Perinatal outcome of babies born to black South African women with hypertension

Background: Perinatal mortality rates (PMR) associated with hypertension ar e known to be high but there have been isolated reports that primigravidae who develop hypertension late in pregnancy have a better PR;IR than normote nsive gravid women. Objective: To verify this report and compare the perinatal outcome in diffe ring categories of hypertensive disorders of pregnancy. Design: Maternal and neonatal data were recorded for all hypertensive patie nts admitted to King Edward VIII Hospital over a six month period from Janu ary to June 1995, In addition, similar data from normotensive women matched for age, parity and gestational age were also recorded. The Tatter formed the control group. Results: Three hundred and thirty seven women were entered into the study. Group A consisted of 189 patients with hypertension, while group B consiste d of 148 normotensive pregnant women, There were no significant differences between the groups in relation to maternal age and parity. More women in t he hypertensive group had Caesarean sections than in the control group (stu dy group 115 versus control 35: p = 0.001). The perinatal outcome (SBs + NN Ds) was significantly greater in the control group than in the hypertensive group (p = 0.031). More importantly, the number of perinatal deaths in the aproteinuric group was significantly different from the control group (apr oteinuric group = 2; control group = 26, p = 0.007), Furthermore, the hyper tensive group had greater foetal weights than the control groups (controls 1.65kg versus 2.3kg hypertensives: p = 0.0001). Conclusion: This study shows that babies born to hypertensive mothers have a significantly greater birthweight than a control group of normotensive wo men. Further, although there are no statistically significant differences i n perinatal outcome between moderate and severe categories of hypertension and control patients, there were significantly fewer perinatal deaths in wo men with aproteinuric hypertension.