HYPERTENSION IN PREGNANCY - MATERNAL AND FETAL OUTCOMES ACCORDING TO LABORATORY AND CLINICAL-FEATURES

Objectives: To determine the predictive value of clinical and laborato ry parameters for maternal and fetal complications in pregnant women w ith hypertension. Design: Prospective data collection. Setting: Two pr imary referral hospitals in the southern suburbs of Sydney between Mar ch 1987 and July 1994. Subjects: 1183 pregnant women with hypertension managed conjointly by a physician and obstetrician. Intervention: Uni form management protocol, plus antihypertensive medications if systoli c blood pressure was persistently greater than or equal to 160 mmHg an d/or diastolic blood pressure greater than or equal to 90 mmHg. Main o utcome measures: Maternal and fetal complications, as defined by the A ustralasian Society for the Study of Hypertension in Pregnancy Consens us Statement. Results: Of 825 women with pre-eclampsia (502 mild; 323 severe), univariate analysis showed that hyperuricaemia, proteinuria a nd severe hypertension were significantly associated with a higher rat e of maternal and fetal complications. In multivariate analyses withou t confounders, only primiparity, low serum albumin levels and absence of diabetes were significantly associated with severe pre-eclampsia. S evere pre-eclampsia, high haemoglobin levels and low platelet count we re associated with higher rates of small-for-gestational-age babies, b ut only low serum albumin levels were associated with increased perina tal mortality rates. Low birthweight was associated with severe hypert ension and severe pre-eclampsia. Conclusions: Simple clinical and labo ratory parameters are useful predictors for maternal and fetal outcome s in pregnancies complicated by hypertension.