ABSTRACT
Objective
This study aimed to evaluate the prevalence of hypertensive disorders during pregnancy among Brazilian women with preterm births and to compare the epidemiological characteristics and perinatal outcomes among preterm births of women with and without hypertension.
Methods
This was a secondary cross-sectional analysis of the Brazilian Multicenter Study on Preterm Birth. During the study period, all women with preterm births were included and further split into two groups according to the occurrence of any hypertensive disorder during pregnancy. Prevalence ratios were calculated for each variable. Maternal characteristics, prenatal care, and gestational and perinatal outcomes were compared between the two groups using χ2 and t-tests.
Results
A total of 4,150 women with preterm births were included, and 1,169 (28.2%) were identified as having hypertensive disorders. Advanced maternal age (prevalence ratio (PR) 2.49) and obesity (PR= 2.64) were more common in the hypertensive group. The gestational outcomes were worse in women with hypertension. Early preterm births were also more frequent in women with hypertension.
Conclusion
Hypertensive disorders of pregnancy were frequent among women with preterm births, and provider-initiated preterm births were the leading causes of premature births in this group. The factors significantly associated with hypertensive disorders among women with preterm births were obesity, excessive weight gain, and higher maternal age.
Keywords
Premature birth; Hypertension; Hypertension, pregnancy-induced; Infant, premature; Pre-eclampsia; Pregnancy complications, cardiovascular
In Brief
Hypertension during pregnancy affects one-third of preterm deliveries in Brazil, especially in non-white and older women. Women who gain excessive weight during pregnancy are more likely to develop this condition, which is associated with early preterm birth (<34 weeks) through cesarean section because of worsening maternal clinical conditions.
Highlights
Pregnant women with increased weight gain must be surveilled for hypertension.
Non-white and older women are more likely to develop hypertension.
Maternal conditions determine most cases of preterm delivery among women with hypertension.
