Hypertension Disorders in Pregnancy and the Effects on Offspring

Hypertension disorders in pregnancy include gestational hypertension, pre-eclampsia, eclampsia, and chronic hypertension.  These disorders have been shown to complicate between 6% and 20% of pregnancies. Risk factors for hypertensive disorders include increasing maternal age and greater body mass index at the time of pregnancy. These disorders have been shown to enhance the likelihood of small for gestational age offspring, preterm births, and infants with low birth weight. Detection and treatment of hypertension are essential to reduce the risk of the sequelae related to hypertension in pregnancy.  Macdonald-Wallis et al demonstrate the effects of hypertension on offspring in this large prospective study.

Associations of Blood Pressure Change in Pregnancy With Fetal Growth and Gestational Age at Delivery: Findings From a Prospective Cohort

High blood pressure during pregnancy is associated with reduction of intrauterine growth and also with preterm births.  These associations have not been well studied.  This study looked at over 9600 women and children to understand these relationships better.  This study found that higher systolic BPs (not diastolic) at the study’s baseline (8 weeks gestation) and increase in systolic and diastolic blood pressure within 18-36 weeks of gestation were associated with lower birth weights and smaller for gestational age offspring. Greater increases in blood pressure, from the 18-week nadir, are related to decreased fetal growth and shorter gestation time, even in women whose blood pressure does not cross the parameters for hypertensive disorders of pregnancy.  This is the first prospective study to examine hypertension in relation to outcome of offspring.