IMPACT OF MATERNAL HYPERTENSION ON NEONATAL HEALTH OUTCOMES IN A TERTIARY CARE SETTING
Main Article Content
Keywords
Hypertensive disorders of pregnancy, Preeclampsia, Neonatal outcomes, NICU admission, Tertiary care
Abstract
Introduction: Hypertensive disorders of pregnancy (HDP) significantly contribute to maternal and neonatal morbidity and mortality worldwide. This study aimed to evaluate the impact of maternal hypertension on neonatal health outcomes in a tertiary care setting and identify predictors of adverse outcomes.
Methods: A prospective case-control study was conducted over six months, enrolling 152 pregnancies complicated by hypertension and 152 normotensive controls matched for maternal age and parity. Maternal parameters including demographic details, type and severity of hypertension, and pregnancy outcomes were recorded. Neonatal outcomes including birth weight, NICU admission, complications, and mortality were assessed.
Results: Preeclampsia was the most common hypertensive disorder (46.7%), followed by gestational hypertension (35.5%). Hypertensive pregnancies had significantly higher rates of cesarean delivery (63.2% vs. 35.5%, p<0.001), preterm birth (38.2% vs. 10.5%, p<0.001), and lower mean birth weight (2486±562 vs. 2934±424 grams, p<0.001). NICU admission rates were substantially higher in the hypertensive group (44.1% vs. 16.4%, p<0.001), with increased incidence of respiratory distress syndrome (25.7% vs. 9.2%, p<0.001), hypoglycemia (21.1% vs. 7.2%, p<0.001), and neonatal mortality (5.9% vs. 1.3%, p=0.03). A gradient of risk was observed across hypertensive disorders, with eclampsia and chronic hypertension with superimposed preeclampsia associated with the worst outcomes. Multivariate analysis identified eclampsia (aOR 6.45), severe preeclampsia (aOR 3.82), and early-onset disease (aOR 2.94) as significant predictors of NICU admission.
Conclusion: Maternal hypertension significantly increases the risk of adverse neonatal outcomes, with severity varying by hypertensive disorder type. Early detection, close monitoring, and appropriate management are crucial for optimizing outcomes in tertiary care settings.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr. Premlata Yadav
Assistant Professor, Department of Obsterics & Gynecology, United Institute of Medical Sciences, Prayagraj, Uttar Pradesh, India
Dr. Pramod Kumar
Associate Professor, Department of Pediatrics, United Institute of Medical Sciences, Prayagraj, Uttar Pradesh, India
Dr. Ambuj Tripathi
Associate Professor, Department of Pediatrics, United Institute of Medical Science, Prayagraj, Uttar Pradesh