EFFECT OF UNCOMPLICATED CHRONIC HYPERTENSION ON THE RISK OF SMALL-FOR-GESTATIONAL-AGE BIRTH

This study assesses the effect of chronic hypertension on fetal growth , A cohort of 1,938 pregnant women attending five prenatal clinics in France between August 1991 and May 1993 were enrolled in a prospective study, Chronic hypertension was defined according to blood pressure a t enrollment and past history, and cases complicated by preeclampsia w ere excluded. Adjusted odds ratios of small-for-gestational age birth were estimated by logistic regression. The independent effect of chron ic hypertension on mean birth weight was examined through multiple lin ear regression analysis adjusting for gestational age at delivery and potential confounders. Uncomplicated chronic hypertension was associat ed with an increased risk of small-for-gestational age birth. Odds rat ios increased with age. In women over age 30 years, the association wa s strong (adjusted odds ratio = 8.5, 95% confidence interval 2.9-24.5) . Multiple linear regression showed that mean birth weight was 161 g ( 95% confidence interval 66-256 g) less in women with chronic hypertens ion compared with normotensive women. The authors conclude that mean b irth weight is reduced and the risk of small-for-gestational age birth is increased in uncomplicated chronic hypertension compared with norm otensive pregnancies. Results further suggest that the magnitude of th is association increases with age.