Adverse pregnancy outcomes among mothers with hypertensive disorders in pregnancy: A meta-analysis of cohort studies

Fang Li; Tingting Wang; Letao Chen; Senmao Zhang; Lizhang Chen; Jiabi Qin

doi:10.1016/j.preghy.2021.03.001

Adverse pregnancy outcomes among mothers with hypertensive disorders in pregnancy: A meta-analysis of cohort studies

Pregnancy Hypertens. 2021 Jun:24:107-117. doi: 10.1016/j.preghy.2021.03.001. Epub 2021 Mar 20.

Authors

Fang Li¹, Tingting Wang¹, Letao Chen¹, Senmao Zhang¹, Lizhang Chen², Jiabi Qin³

Affiliations

¹ Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan Province 410078, China.
² Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan Province 410078, China. Electronic address: liche4005@126.com.
³ Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan Province 410078, China. Electronic address: qinjiabi123@163.com.

PMID: 33813363
DOI: 10.1016/j.preghy.2021.03.001

Abstract

Background: Presently, the results of studies assessing the association of hypertensive disorders in pregnancy (HDP) with adverse pregnancy outcomes (APOs) in offspring remain inconclusive, and a complete overview is missing. We performed a meta-analysis of cohort studies to review and summarize the association between HDP and risk of APOs in offspring.

Methods: PubMed, Embase, Web of Science and Chinese databases were searched through May 2019 to identify eligible studies. Outcomes of interest were APOs including perinatal death, fetal death, stillbirth, neonatal death, congenital malformations, preterm birth (PTB), very preterm birth (VPTB), intrauterine growth restriction (IUGR), small for gestational age (SGA), low birth weight (LBW), and very low birth weight (VLBW). Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. Subgroup analysis was performed to explore potential heterogeneity moderators.

Results: Total 152 cohort studies involving 1,426,742 mothers with HDP and 36,374,542 mothers without HDP were included for analysis. Overall, mothers with HDP compared with those without HDP had a significantly higher risk of perinatal death (OR = 2.86), fetal death (OR = 2.82), stillbirth (OR = 1.93), neonatal death (OR = 1.55), congenital malformations (OR = 2.66), IUGR (OR = 5.48), SGA (OR = 3.39), LBW (OR = 5.02), VLBW (OR = 1.74), PTB (OR = 4.20) and VPTB (OR = 3.26) in offspring. Relevant heterogeneity moderators were identified by subgroup analyses. The sensitivity analysis yielded consistent results. No evidence of publication bias was observed.

Conclusion: The present study indicates that HDP significantly increases risk of APOs. Further research is needed to explore efficient management methods to minimize the risk of APOs associated with HDP.

Keywords: Adverse pregnancy outcomes; Cohort study; Hypertensive disorders in pregnancy; Meta-analysis.

Publication types

Meta-Analysis
Review

MeSH terms

Adult
Female
Fetal Growth Retardation
Humans
Hypertension, Pregnancy-Induced / epidemiology
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Pre-Eclampsia
Pregnancy
Pregnancy Outcome / epidemiology*
Premature Birth
Stillbirth