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CC BY 4.0 · Am J Perinatol
DOI: 10.1055/a-2568-9104
Original Article

Maternal and Neonatal Outcomes in Gestational Hypertension for Delivery at 37 versus 38 to 40 Weeks

Lauren Thompson 
1   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
Joseph Werthammer 
1   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
Grace Montgomery
2   Department of Obstetrics and Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
Matthew Nudelman
3   Section of Applied Clinical Informatics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
,
Jesse Cottrell 
4   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
David Gozal
5   Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
Rebekah Fabela
1   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
,
Kennedy Snavely
6   Marshall University Joan C. Edwards School of Medicine, Huntington, West Virginia
› Institutsangaben Funding None.
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Abstract

Objective

This study aimed to compare neonatal and maternal outcomes for mothers with gestational hypertension delivered at 37 weeks' gestation compared with 38 to 40 weeks.

Study Design

Single-center, retrospective chart review of women with gestational hypertension delivered between 370/7 and 406/7 weeks' gestation over a 29-month period.

Results

A total of 337 mother–infant dyads with gestational hypertension were included: 194 delivered at 37 weeks' gestation (cohort 1) and 143 delivered at 38 to 40 weeks' gestation (cohort 2). Preeclampsia developed in 12% of cohort 1 and 8% of cohort 2 (p = 0.242). No significant differences in severe hypertensive-related complications were found between the cohorts. Neonatal outcomes including neonatal intensive care unit admission, respiratory support, phototherapy, and length of stay were all more frequent in cohort 1.

Conclusion

For women with gestational hypertension, delivery at 38 to 40 weeks was not associated with increased maternal complications but was associated with fewer neonatal complications when compared with delivery at 37 weeks.

Key Points

  • Gestational hypertension is a common complication of pregnancy.

  • Mothers with gestational hypertension are often induced early.

  • Neonatal adverse outcomes increase with early delivery.

  • Optimal timing of delivery for pregnancies complicated by gestational hypertension is unknown.

Keywords

gestational hypertension - timing of delivery - preeclampsia - maternal hypertensive disorders - adverse perinatal outcomes


Publikationsverlauf

Eingereicht: 21. Januar 2025

Angenommen: 24. März 2025

Accepted Manuscript online:
31. März 2025

Artikel online veröffentlicht:
17. April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
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  • References

  • 1 Unger T, Borghi C, Charchar F. et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens 2020; 38 (06) 982-1004
    Suche in Google Scholar
  • 2 Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011; 25 (04) 391-403
    Suche in Google Scholar
  • 3 Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol 2013; 170 (01) 1-7
    Suche in Google Scholar
  • 4 Ford ND, Cox S, Ko JY. et al. Hypertensive disorders in pregnancy and mortality at delivery hospitalization - United States, 2017-2019. MMWR Morb Mortal Wkly Rep 2022; 71 (17) 585-591
    Suche in Google Scholar
  • 5 Thornton J, Duley L. Gestational hypertension before term: observe or deliver?. Lancet 2015; 385 (9986) 2441-2443
    Suche in Google Scholar
  • 6 Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009; 33 (03) 130-137
    Suche in Google Scholar
  • 7 Steegers EAP, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet 2010; 376 (9741) 631-644
    Suche in Google Scholar
  • 8 Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367 (9516) 1066-1074
    Suche in Google Scholar
  • 9 Cunningham FG, Leveno KJ, Bloom SL. et al. Pregnancy hypertension. In: Cunningham FG. ed. Williams Obstetrics. 23rd ed.. New York: McGraw-Hill Professional; 2009
    Suche in Google Scholar
  • 10 Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183 (01) S1-S22
    Suche in Google Scholar
  • 11 Barton JR, O'brien JM, Bergauer NK, Jacques DL, Sibai BM. Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol 2001; 184 (05) 979-983
    Suche in Google Scholar
  • 12 Gestational hypertension and preeclampsia: ACOG Practice Bulletin, number 222. Obstet Gynecol 2020; 135 (06) e237-e260
    Suche in Google Scholar
  • 13 Brown MA, Magee LA, Kenny LC. et al; International Society for the Study of Hypertension in Pregnancy (ISSHP). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens 2018; 13: 291-310
    Suche in Google Scholar
  • 14 Koopmans CM, Bijlenga D, Groen H. et al; HYPITAT study group. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet 2009; 374 (9694) 979-988
    Suche in Google Scholar
  • 15 Magee LA, Kirkham K, Tohill S. et al; WILL Trial Study Group. Determining optimal timing of birth for women with chronic or gestational hypertension at term: the WILL (When to Induce Labour to Limit risk in pregnancy hypertension) randomised trial. PLoS Med 2024; 21 (11) e1004481
    Suche in Google Scholar
  • 16 Cruz MO, Gao W, Hibbard JU. What is the optimal time for delivery in women with gestational hypertension?. Am J Obstet Gynecol 2012; 207 (03) 214.e1-214.e6
    Suche in Google Scholar
  • 17 Addicott K, Nudelman M, Putty K. et al. Adverse perinatal outcomes associated with increasing maternal obesity. Am J Perinatol 2024; 41 (09) 1275-1281
    Suche in Google Scholar
  • 18 Adams-Chapman I. Neurodevelopmental outcome of the late preterm infant. Clin Perinatol 2006; 33 (04) 947-964 , abstract xi
    Suche in Google Scholar
  • 19 Srinivas Jois R. Neurodevelopmental outcome of late-preterm infants: a pragmatic review. Aust J Gen Pract 2018; 47 (11) 776-781
    Suche in Google Scholar
  • 20 Woythaler M. Neurodevelopmental outcomes of the late preterm infant. Semin Fetal Neonatal Med 2019; 24 (01) 54-59
    Suche in Google Scholar