ANTI-HYPERTENSIVE DRUGS AND PERINATAL OUTCOMES IN HYPERTENSIVE WOMEN ATTENDING A TERTIARY HOSPITAL

Abstract

Objective: This study was aimed to determine the impact of hypertension and the used anti-hypertensive medications on perinatal (maternal and fetal) outcomes and to determine the most commonly used anti-hypertensive medications in order to compare their maternal and fetal outcomes. Design and method: The medical records of 484 hypertensive pregnant women attending a tertiary hospital, were evaluated. Singleton pregnancies of the women who were on anti-hypertensive medications and delivered in the hospital were included in the study. Multiple pregnancies, molar pregnancies and the women who were not on anti-hypertensive medications or did not deliver in the hospital were excluded from the study. Based on inclusion and exclusion criteria, 210 women were included. The data of types of hypertension, the used anti-hypertensive drugs, fetal and maternal outcomes were gathered from patient's medical records. Result(s): The mean age of the studied population was 32.4 +/-5.6 years and the mean BMI was 34 +/-8.1 Kg/m2. The most prevalent sub-type of hypertension was preeclampsia (41.4%). Low birth weight, preterm delivery, intrauterine growth restriction (IUGR), small for gestational age (SGA), respiratory distress syndrome and neonatal care unit admissions were significantly higher in women with preeclampsia than in the women with other types of hypertension. Labetalol was the most common prescribed anti-hypertensive drug. There were 101 (48.1%) women on combined therapy. Preeclampsia was significantly more prevalent in women who received labetalol alone than women who received methyldopa alone (50% Vs 16%, P = <0.001)). Low birth weight, preterm delivery, IUGR, SGA, respiratory distress syndrome, absent end diastolic flow and neonatal care unit admission of newborns were significantly higher in the women who received combined therapy. Preeclampsia and high dependency unit admissions were also significantly higher in women who received combined therapy. Conclusion(s): This study showed that that pregnant women on combined antihypertensive medications had significantly higher maternal and fetal outcomes. This could be due to more severe or uncontrolled hypertension in these women. T.