A study in the Canadian Medical Association Journal (CMAJ.ca) has sounded a warning bell for hypertensive disorders that may contribute to morbidity (overall poor health) during pregnancy.
Hypertensive disorders of pregnancy (HDP) include pre-existing (chronic) hypertension, gestational hypertension, and pre-eclampsia or eclampsia, said the study.
In general terms, the study said hypertensive disorders can affect five to 10 per cent of the population and the result is that it causes thousands of deaths around the world.
In Canada, severe pre-eclampsia was the most common contributor to severe maternal morbidity (SMM) from 2012 to 2016.
Although pre-eclampsia and eclampsia pose the greatest risk, all forms of HDP heighten the risk of adverse pregnancy outcomes, including long-term risk of cardiovascular and metabolic disease, said the study.
The CMAJ study gathered data from hospitals across the country (excluding Quebec) to identify females who had an HDP diagnosis during a birth admission between 2012 and 2021.
The study discovered in that period the rate of HDP among Canadian women rose from 6.1 per cent to 8.5 per cent. This included pre-existing hypertension, gestational hypertension and pre-eclampsia, said the study.
It was also found that for females with any sort of hypertension, the rates of cesarean delivery rose from 42 per cent in 2012, to 44.3 per cent in 2021. An increase was also seen in acute renal failure for those patients.
At the same time, there was a downward trend for rates of early preterm delivery, intrauterine fetal death, maternal hospital length of stay, admission to the maternal intensive care unit, severe hemorrhage, and SMM, said the study.
The study authors interpreted the data to show that "the rate of HDP has risen across Canada, with a concomitant decline in some HDP-associated morbidities. Ongoing surveillance of HDP is needed to assess the factors associated with temporal trends, including the effectiveness of evolving HDP prevention and management efforts."
The study concluded that although HDP has risen in Canada, the decline in HDP-associated morbidity may reflect improvements in management of blood pressure along with timing of birth for mothers affected by HDP.
"Ongoing surveillance of HDP — including newborn outcomes — should assess the factors associated with temporal trends, including the effectiveness of evolving HDP prevention and management efforts," said the study.
A full text version of the report from CMAJ is available online here.
Len Gillis covers health care and mining for Sudbury.com.
