Feto-maternal outcomes in hypertensive disorders of pregnancy: a prospective community-based cohort study in rural central India.

OBJECTIVE

To assess the prevalence of hypertensive disorders of pregnancy (HDP) and their impact on maternal and neonatal outcomes in a rural population of Central India.

STUDY

DESIGN

A prospective, community-based cohort study was conducted over three years at a rural tertiary care centre, covering approximately 100,000 residents in 100 villages. A total of 1,650 pregnant women (<20 weeks of gestation) were enrolled through door-to-door surveys and followed monthly until one month postpartum. Data on maternal and neonatal outcomes were collected and analysed using SPSS 20.0, with p < 0.05 considered statistically significant.

MAIN OUTCOME MEASURES: Incidence and types of HDP; maternal complications; gestational age at delivery; mode and place of delivery; neonatal birth weight; neonatal morbidities; and perinatal mortality.

RESULTS

The incidence of HDP was 7.15% (118/1650). Gestational hypertension (non-severe features) was most common (53.4%), followed by preeclampsia with severe features (16.9%). Hypertensive women had significantly higher rates of infertility history (6.8% vs. 3%, p = 0.009) and previous child loss (6.8% vs. 2.48%, p = 0.006). Preterm delivery (<37 weeks) occurred in 17.8% of hypertensive women versus 8.03% in normotensive women (p = 0.0002). Cesarean section rates were higher in the HDP group (36.4% vs. 22%, p = 0.0001). Maternal complications such as anaemia (22.9% vs. 3.3%), thrombocytopenia (7.6% vs. 0.5%), and placental abruption (3.4% vs. 0.1%) were significantly more frequent. Neonates of hypertensive mothers had higher rates of low birth weight (35.6% vs. 22.5%), small for gestational age (53.4% vs. 19.8%), preterm birth (16.9% vs. 5.42%), and perinatal mortality (6.8% vs. 1.8%).

CONCLUSION

HDP significantly increases the risk of adverse maternal and neonatal outcomes, including preterm birth, cesarean delivery, low birth weight, and perinatal mortality. Early detection, close monitoring, and delivery in well-equipped tertiary centres are essential to improving fetomaternal outcomes, particularly in rural settings.