Pregnancy outcomes in healthy nulliparas who developed hypertension. Calcium for Preeclampsia Prevention Study Group.
2000 Jan
Journal Article
Authors:
Hauth, J.C.;
Ewell, M.G.;
Levine, R.J.;
Esterlitz, J.R.;
Sibai, B.;
Curet, L.B.;
Catalano, P.M.;
Morris, C.D.
Secondary:
Obstet Gynecol
Volume:
95
Pagination:
24-8
Issue:
1
PMID:
10636496
DOI:
10.1016/s0029-7844(99)00462-7
Keywords:
Adult; Female; Humans; hypertension; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Outcome
Abstract:
OBJECTIVE: To determine maternal and perinatal outcomes in nulliparas with pregnancy-associated hypertension or preeclampsia.METHODS: We conducted (and reported elsewhere) a randomized, double-masked, placebo-controlled trial calcium supplementation of 4589 healthy nulliparas assigned at 13-21 weeks' gestation. This well-defined and characterized data set provided an opportunity to detail more precisely adverse maternal, fetal, and newborn outcomes in women who developed hypertension among a prospective series of healthy nulliparas.RESULTS: Of 4302 women observed to or beyond 20 weeks' gestation, 1073 (24.9%) developed mild or severe pregnancy-associated hypertension or preeclampsia. One hundred sixteen women of the 1073 with hypertension (10.8%) and 336 of the 3229 without hypertension (10.4%) were delivered before 37 weeks' gestation. Fetal and neonatal mortality were similar in those groups; however, selected maternal and newborn morbidities were significantly greater in women with hypertension. Significantly increased maternal morbidities included increased cesarean deliveries, abruptio placentae, and acute renal dysfunction; and significantly increased perinatal morbidities included respiratory distress syndrome, ventilatory support, and fetal growth restriction. Adverse outcomes were highest in women with severe pregnancy-associated hypertension or preeclampsia.CONCLUSION: Hypertension, especially severe hypertension, was associated with an appreciable increase in important maternal and perinatal morbidity but not perinatal mortality.
