Impact of a case management model on maternal and neonatal outcomes in gestational hypertension: a randomized controlled trial.

OBJECTIVE

This study aimed to evaluate the effectiveness of a case management model in the comprehensive management of gestational hypertension, focusing on its impact on blood pressure control, pregnancy complications, neonatal health, and maternal satisfaction.

METHODS

A randomized controlled trial was conducted, enrolling 100 pregnant women with hypertension who attended the high-risk outpatient clinic of our hospital from March 2023 to March 2025. Participants were randomly assigned to either an experimental group (n = 50), which received a case management model intervention, or a control group (n = 50), which received standard prenatal care. The two groups were compared regarding blood pressure control, incidence of pregnancy complications, gestational age at delivery, preterm birth rate, birth weight, low birth weight incidence, neonatal transfer rate, and maternal satisfaction. Statistical analyses were conducted using SPSS 23.0, with a significance level of P < 0.05.

RESULTS

The experimental group showed significantly better blood pressure control, with lower systolic and diastolic blood pressure levels compared to the control group (P < 0.05). The incidence of pregnancy complications, such as preeclampsia, placental abruption, and Hemolysis, Elevated Liver Enzymes, and Low Platelet count (HELLP) syndrome, was significantly reduced in the experimental group (P < 0.05). Additionally, the experimental group had an extended gestational age at delivery, a lower preterm birth rate, and higher birth weight (P < 0.05). Neonatal outcomes were improved, as evidenced by a significant reduction in the incidence of low birth weight and neonatal transfer rates (P < 0.05). Maternal satisfaction with care was also significantly higher in the experimental group (P < 0.01).

CONCLUSION

The case management model significantly improved maternal and neonatal outcomes by enhancing blood pressure control, reducing pregnancy complications, and increasing maternal satisfaction. These results support the integration of case management into standard care for pregnant women with hypertension to optimize pregnancy outcomes.