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Hypertension

Poster Session 2

(638) Assessment of Maternal and Neonatal Outcomes in Newly Diagnosed Intrapartum Gestational Hypertension

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Hypertensive disorders, including gestational hypertension (HTN) are a leading cause of adverse perinatal outcomes. There are currently limited data assessing these same outcomes in individuals who are diagnosed with intrapartum HTN only. The objective of this study was to compare the rate of progression to preeclampsia (PET) in intrapartum HTN versus gestational HTN. Our hypothesis was that intrapartum HTN was associated with a lower rate of progression to PET.

Study Design:

A retrospective cohort study was performed comparing the rate of progression to PET between gestational HTN and intrapartum HTN (defined as at least two elevated BPs (140 mmHg systolic or 90 mmHg diastolic) at least 4 hours apart, occurring only during the intrapartum period and not in the current or prior pregnancies). 142 individuals were included in the gestational HTN group, and 25 in the intrapartum group. The primary outcome was defined as the rate of PET in each group. Secondary outcomes included mode of delivery, severe features and neonatal outcomes (NICU admission, hypoglycemia, respiratory support, mortality). Statistical analysis was performed using Fisher’s Exact Test.

Results: The two groups were similar in age, BMI, and demographics. The intrapartum HTN group was more likely to be nulliparous (80% vs 67.6%) and later in gestation (39.3 vs 37.0 weeks) compared with the gestational HTN group. The development of PET was higher with gestational HTN compared to intrapartum HTN (85.9% vs 64.0%, p=0.018). In the secondary outcomes NICU admissions were increased in gestational HTN compared with the intrapartum HTN (31.9% vs 8%, p=0.015).

Conclusion: Individuals with intrapartum HTN are less likely to progress to PET than those with gestational HTN. However, the rates of PET in both groups are quite high and limited outcomes for the patient and newborn were examined. As intrapartum HTN has not been extensively evaluated previously, more research is needed to further characterize the impact of this diagnosis and potential management strategies to improve outcomes.