To assess the impact of studied maternal parameters (age, diabetes mellitus (DM), quantitative proteinuria, serum uric acid, number of antihypertensive drugs used, multiple pregnancy) on fetal outcome (birth weight, duration of pregnancy, Apgar score).Design and method:
308 mothers with hypertension in pregnancy and their 339 fetuses were included. Pregnant women aged 32 (18–46; median, range) years were admitted to the St. Cyril and Methodius Hospital due to hypertension in pregnancy (4% with purely pre-existing hypertension) from June 2011 to June 2015. DM was present in 16% of women (type 1 DM in 7%, type 2 DM in 1.5% and gestational DM in 7.5%). Maternal antihypertensive treatment was evaluated until the day of delivery. In case of repeated measurement of maternal proteinuria and serum uric acid, the highest ante-partum value was used.Results:
Out of 339 fetuses, 335 were born alive, 84% per Caesarean section. Duration of gestation was 37 (24–42; median, range) weeks, birth weight 2600 (370–4820) g, proteinuria 0.580 (0.06–20.04) g/24 h, serum uric acid 344 (194–633) μmol/l. Most pregnant women (38%) were treated with 2 antihypertensive drugs, 32% with one drug, 23% with 3 drugs, 6% with 4 drugs and one woman with 5 drugs. The most frequently used antihypertensive drugs were methyldopa (97% women), isradipine (51%), i.v./oral urapidil (45%), metoprolol (8%) and amlodipine (7%).Results:
Shorter duration of pregnancy and lower birth weight were associated with higher proteinuria and higher number of antihypertensives (p < 0.0001 for all correlations). Apgar score at 1 and 5 minutes was negatively correlated to proteinuria (p < 0.01), but not to the number of antihypertensives or other parameters.Conclusions:
In our study, only maternal proteinuria and number of antihypertensives needed to control blood pressure in pregnant hypertensive women had negative impact on fetal outcome. Proteinuria and number of antihypertensives were associated with shorter duration of pregnancy and lower birth weight. Proteinuria had negative influence on Apgar scores.