Chronic Hypertension Increases Risk of Pregnancy Complications Interview with:
Dr Kate Bramham
Division of Women’s Health
King’s College London
Women’s Health Academic Centre KHP
London, SE1 7ER What are the main findings of the study?

Dr. Bramham: This meta-analysis of nearly 800,000 pregnancies from 55 studies has shown that women with chronic hypertension have a significantly increased incidence of pregnancy complications including superimposed pre-eclampsia, preterm delivery, low birth weight infants, perinatal loss and neonatal unit admission. Were any of the findings unexpected?

Dr. Bramham: Superimposed pre-eclampsia is associated with substantial maternal and neonatal morbidity and mortality. The incidence of superimposed pre-eclampsia compared with the incidence of pre-eclampsia in the general population was eight-fold higher, which was considerably greater than previously thought. What should clinicians and patients take away from your report?

Dr. Bramham: Clinicians should be aware that women with chronic hypertension should have their blood pressure controlled before pregnancy, should be referred early to specialist obstetric care and need to be carefully monitored for complications during their pregnancy. Patients need to be aware of the increased risk of pregnancy complications, and the importance of frequent antenatal surveillance. What recommendations do you have for future research as a result of this study?

Dr. Bramham: The number of women affected by chronic hypertension in pregnancy is increasing. These data suggest that understanding underlying mechanisms of pregnancy complications, particularly superimposed pre-eclampsia, is an important area of future research.


Bramham K ,Parnell B ,Nelson-Piercy C ,Seed PT ,Poston L ,Chappell LC. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis.
BMJ 2014;348:g2301



Last Updated on April 30, 2014 by Marie Benz MD FAAD