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Factors Associated with Perinatal Mortality in Adult Pregnant Women with Hypertensive Disorders: A Case–Control Study

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A Correction to this article was published on 22 November 2023

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Abstract

Background

Hypertension complicates 5–10% of pregnancies and is a common cause of perinatal death. The perinatal mortality is estimated to be 3 to 5 times higher in hypertensive women compared to those without hypertension.

Methods

A hypertensive mother either with a stillbirth or if baby died within 7 days of life was included as a case. Once a case was recognized, the next two consecutive hypertensive mothers who delivered a live baby, who survived up to 7 days of life, were taken as controls. Fetuses with congenital malformations incompatible with life and multiple pregnancies were excluded from the study. One hundred and twelve women in cases and 224 women in controls were studied.

Results

Among 112 cases of perinatal death, 70% had died in utero before labor. Among the 33 fetuses alive, 50% were born still after labor and 50% died within 7 days of birth. We found that early onset hypertension (< 34 weeks) (p-< 0.001 (Chi2-23.819)), gestational age at termination of 28–32 weeks (OR 2.76), value of serum creatinine > 1.1 mg/dl (OR 10.1), abruption (OR 6.2) and birth weight < 1.5 kg was significantly associated with perinatal mortality (p-0.007, OR 5.7). Abnormal Doppler findings was a predictor of perinatal deaths.

Conclusion

Severely growth retarded fetuses in association with early onset severe preeclampsia are likely to die in utero and need vigilant monitoring antenatally. Abnormal umbilical artery Dopplers predict perinatal mortality. Caesarean section at the gestational age of ≥ 32 weeks and an estimated fetal weight of ≥ 1.2 kg in our hospital resulted in favorable outcome.

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Acknowledgements

We acknowledge the authorities of JIPMER for allowing us to use the infrastructure of JIPMER for carrying out the study.

Funding

This research did not receive any specific grant from funding agencies in the public commercial, or not-for-profit sectors.

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Author notes

  1. Blessy John

    Present address: Specialist Obstetrics and Gynecology, KIMSHEALTH Hospital, Umm Al Hassam, Manama, 75829, Kingdom of Bahrain

Authors and Affiliations

  1. Professor and HOD, Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, 605 006, India

    Blessy John & Gowri Dorairajan

  2. Additional Professor, Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, 605 006, India

    Palanivel Chinnakali

  3. Additional Professor and HOD, Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, 605 006, India

    Nivedita Mondal

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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Blessy John. Analysis was performed by Blessy John, Gowri Dorairajan and Palanivel Chinnakali. The first draft of the manuscript was written by Blessy John and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Blessy John.

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Conflict of Interests

All the authors declare that there is no conflict of interest.

Ethical Approval

The study was approved by the Institute Ethics Committee (Human Studies) Reg. No: ECR/342/Inst/PY/2013 in JIPMER, India.

Informed Consent

Individual consent was obtained from all the individual participants included in this study and for publication of results of the study.

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Dr Blessy John, Senior Resident; Dr Gowri Dorairajan, Professor and HOD; Dr Palanivel Chinnakali, Additional Professor; Dr Nivedita Mondal, Professor and HOD.

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John, B., Dorairajan, G., Chinnakali, P. et al. Factors Associated with Perinatal Mortality in Adult Pregnant Women with Hypertensive Disorders: A Case–Control Study. J Obstet Gynecol India 73 (Suppl 1), 11–18 (2023). https://doi.org/10.1007/s13224-023-01782-8

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