A comparative study of obstetric outcome of patients with pregnancy induced hypertension: Economic considerations

Background. Hypertension in pregnancy is associated with increased maternal and fetal morbidity and mortality. The aim of this prospective study was to evaluate the obstetric outcome of patients with pregnancy induced hypertension (PIH) that delivered at the Maternity Hospital Kuwait within a period of six months and evaluate the economic implications of present management strategies. Methods. This was a comparative study with age and parity, as matching variables, in 224 pregnant hypertensive women and 224 normotensive controls. Results. During the study period, the incidence of PIH was 4.9 percent. They were more associated with diabetes mellitus and multiple pregnancy than controls (p<0.02). About 43 percent of the hypertensive parturients used antihypertensive therapy. More of them had induction of labor (p<0.001), preterm delivery (p<0.0002) and cesarean section (p<0.001), and babies with low birth weight (p<0.01). In the linear regression analysis, hypertension in pregnancy gave rise to more hospitalisation, intrauterine growth retardation and operative deliveries than the normotensive controls. The perinatal mortality was higher (p<0.001). Conclusion. Despite the economic expenditure of about five times more for hypertensive women in pregnancy than in controls, both obstetric and neonatal outcome, are still significantly worse in the former. This study therefore advocates more research into the prevention, prediction and management, including neonatal care, of hypertensive disorders of pregnancy.