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- Title
PRIMARY GESTATIONAL HYPERTENSION /PREECLAMPSIA IN MULTIGRAVIDA AT A TERTIARY HOSPITAL.
- Authors
Geetha K.; Sulochana
- Abstract
BACKGROUND Gestational hypertension and preeclampsia are major causes of an array of adverse maternal & foetal outcome. Even though previous history is the strongest risk factor among multigravida, the incidence of preeclampsia is on raise with life style changes. High prepregnancy BMI and increase in the BMI between pregnancies contribute significantly to an adverse outcome. Birth interval is more is usually associated with increase in maternal age and more chance for maternal weight gain. Prior preterm delivery is also known to increase the risk of preeclampsia/ gestational hypertension in women with & without preeclampsia in previous pregnancy. Increase in maternal age and exorbitant gestational weight gain are known to increase the risk of preeclampsia. This prospective observational study was conducted to determine the incidence of primary gestational hypertension/ preeclampsia in multigravida & to delineate its risk factors. MATERIALS AND METHODS This study was carried out between February 2009 and January 2011 in a tertiary care hospital among multigravid pregnant women booked at the antenatal clinic. Multigravida with 2 or more singleton pregnancies with records of previous pregnancies furnishing lack of evidence of GHT/ preeclampsia and those with complications like HT, DM, renal disease, autoimmune disease with their onset in the interpregnancy period were included in the study. Data was analysed for the risk variables among the total group and the results were expressed as percentages. Qualitative analysis was done using the chi square test. Value of less than 0.05 was taken as significant. RESULTS After all exclusions, the final cohort consisted of 723 women with 2 or more consecutive singleton pregnancies. Incidence of primary gestational hypertension/ preeclampsia among parous women in the study population was 4.8%. Incidence of gestational hypertension was 3%, while preeclampsia was 1.7%. Majority of patients among GHT were in the 31-35 yrs age group (36.4%) while preeclampsia was more frequent in > 35yrs (38.5%). Elderly gravida was observed to be a notable risk factor. The percentage of overweight & obese women was more among cases compared with the remaining multigravida. Change in BMI of more than 1 unit compared to previous pregnancy was seen to be an important risk factor. Exorbitant gestational weight gain, chronic hypertension & diabetes mellitus were also significant risk factors for primary onset of GHT/preeclampsia in multigravida. CONCLUSION This study infers that there is a significant association between- high prepregnancy BMI (overweight/ obesity), change in prepregnacy BMI between pregnancies (of more than 1 unit), advanced maternal age (>35yrs), excessive gestational weight gain in pregnancy, chronic hypertension and diabetes mellitus prior to present pregnancy with their onset in the interpregnancy period, with gestational HT/ preeclampsia in the index pregnancy among parous women with previous normal pregnancies.
- Subjects
HYPERTENSION in women; WEIGHT gain; FETAL macrosomia; PREMATURE labor; MATERNAL age; PREGNANT women; OBESITY
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2024, Vol 15, Issue 3, p47
- ISSN
0975-3583
- Publication type
Article