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Cited by 218Pregnancy and preeclampsia studiesNeurological Complications and SyndromesGlobal Maternal and Child Health

The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study

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Allen, Victoria M, Joseph, KS, Murphy, Kellie E, Magee, Laura A, Ohlsson, Arne·2004·BMC Pregnancy and Childbirth
DOI 10.1186/1471-2393-4-17PMC PMC515178
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Abstract

Background: Hypertensive disorders in pregnancy are leading causes of maternal, fetal and neonatal morbidity and mortality worldwide. However, studies attempting to quantify the effect of hypertension on adverse perinatal outcomes have been mostly conducted in tertiary centres. This population-based study explored the frequency of hypertensive disorders in pregnancy and the associated increase in small for gestational age (SGA) and stillbirth. Methods: We used information on all pregnant women and births, in the Canadian province of Nova Scotia, between 1988 and 2000. Pregnancies were excluded if delivery occurred < 20 weeks, if birthweight was < 500 grams, if there was a high-order multiple pregnancy (greater than twin gestation), or a major fetal anomaly. Results: The study population included 135,466 pregnancies. Of these, 7.7% had mild pregnancy-induced hypertension (PIH), 1.3% had severe PIH, 0.2% had HELLP (hemolysis, elevated liver enzymes, low platelets), 0.02% had eclampsia, 0.6% had chronic hypertension, and 0.4% had chronic hypertension with superimposed PIH. Women with any hypertension in pregnancy were 1.6 (95% CI 1.5–1.6) times more likely to have a live birth with SGA and 1.4 (95% CI 1.1–1.8) times more likely to have a stillbirth as compared with normotensive women. Adjusted analyses showed that women with gestational hypertension without proteinuria (mild PIH) and with proteinuria (severe PIH, HELLP, or eclampsia) were more likely to have infants with SGA (RR 1.5, 95% CI 1.4–1.6 and RR 3.2, 95% CI 2.8–3.6, respectively). Women with pre-existing hypertension were also more likely to give birth to an infant with SGA (RR 2.5, 95% CI 2.2–3.0) or to have a stillbirth (RR 3.2, 95% CI 1.9–5.4). Conclusions: This large, population-based study confirms and quantifies the magnitude of the excess risk of small for gestational age and stillbirth among births to women with hypertensive disease in pregnancy.

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  • Hypertensive pregnancy disorders, compromised fetal growth, and fetal death often stem from placental dysfunction-either due to insufficient initial placentation or diminishing placental function with increasing gestational age.

    “In particular, hypertensive pregnancy disorders, compromised fetal growth, and fetal death often stem from placental dysfunction—either due to insufficient initial placentation or diminishing placental function with increasing gestational age14,15.”

    From Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization (2023) · cites this paper as [14]

    The Discussion (page unavailable) reports that hypertensive pregnancies had higher risks of small-for-gestational-age birth and stillbirth. The paper does not attribute these outcomes or hypertensive disorders to placental dysfunction, inadequate initial placentation, or declining placental function with gestational age. (LLM, conf=0.85)

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1 of the 34 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Ananth CV Savitz DA Luther ER Bowes WA Preeclampsia and preterm birth subtypes in Nova Scotia, 1986–1992 Am J Perinatol 1997 14 17 23 9259891
  2. Fair M Cyr M Allen AC Wen SW Guyon G MacDonald RC Validation study for a record linkage of births and infant deaths in Canada. Ottawa: Statistics Canada 1999 10813688

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Authors
Allen, V. M., Joseph, K., Murphy, K. E., Magee, L. A., & Ohlsson, A.
Affiliations
  • Dalhousie University (CA)
  • University of Toronto (CA)
  • University of British Columbia (CA)
Corresponding author
Allen, Victoria M
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2004-08-06
Volume
4
Issue
1
Pages
17-17
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/1471-2393-4-17
PMC
PMC515178
OpenAlex
W1720024051
Cited by
218
References
34
Citations by year
2026: 7 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 12 · 2021: 17 · 2020: 11 · 2019: 18 · 2018: 17 · 2017: 10 · 2016: 8 · 2015: 9 · 2014: 15 · 2013: 16 · 2012: 7
FWCI
5.42
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
hypertensive disorders of pregnancy, small for gestational age, stillbirth, gestational hypertension, HELLP syndrome, eclampsia, chronic hypertension in pregnancy, pre-existing hypertension, proteinuria, perinatal outcomes, Nova Scotia

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