Factor analysis, including antihypertensive medication, of the outcome of pregnancy in pregnancy-associated hypertension.
OBJECTIVE
To study the influence of different maternal factors, including antihypertensive medication, on the outcome of pregnancy in primi- and multiparas with pregnancy-associated hypertension.


METHODS
A retrospective, multiple-variate analysis was undertaken of the influence of several maternal factors, including antihypertensive medication, on fetal death and Apgar scores and the correlation between the medication and the number of caesarean sections in 127 episodes of pregnancy-associated hypertension was studied for the whole group as well as for primi- and multiparas separately. Of the multiparas, 40.8% had a history of preeclampsia, 19.7% of chronic hypertension and 9.2% of diabetes mellitus. Antihypertensive treatment aimed at achieving a blood pressure of 140/90 mm Hg. Forty-one patients (32.3%) received intravenous hydralazine, 25 (19.7%) received nifedipine per os and 44 (34.6%) received labetalol per os.


RESULTS
The maximum systolic and diastolic blood pressure in the patients given intravenous hydralazine, nifedipine per os or labetalol per os did not differ, whereas in the multiparas, the number of patients who reached the target blood pressure while using labetalol was higher than with the two other medications, especially in comparison with intravenous hydralazine. For the primiparas, the time of delivery was the only factor with a significant impact on the Apgar scores. In the multiparas, there was an additional negative influence of the use of intravenous hydralazine. This was not seen in the patients using nifedipine and labetalol.


CONCLUSIONS
The results suggest that in multiparas, intravenous hydralazine is possibly associated with more fetal distress when compared to primiparas.
Hussein
M
M
Department of Nephrology, Dialysis and Hypertension, Al Hada Armed Forces Hospital, Taif, Saudi Arabia.
Mooij
J M
JM
Roujouleh
H
H
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D015897:Comorbidity; D004198:Disease Susceptibility; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007231:Infant, Newborn; D007741:Labetalol / Q000627:therapeutic use; D015999:Multivariate Analysis; D009543:Nifedipine / Q000627:therapeutic use; D010298:Parity; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
D000959:Antihypertensive Agents; D006830:Hydralazine; D009543:Nifedipine; D007741:Labetalol