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Trends in rate of hypertensive disorders of pregnancy and associated morbidities in Canada: a population-based study (2012-2021)
- Source :
- CMAJ: Canadian Medical Association Journal. July 29, 2024, Vol. 196 Issue 26, , E897, p8 p.
- Publication Year :
- 2024
-
Abstract
- Background: Hypertensive disorders of pregnancy (HDP) are a leading cause of severe maternal morbidity (SMM). We sought to explore trends in HDP and related morbidity outcomes in Canada. Methods: In this retrospective population-based study, we used hospital discharge data from Canada, excluding Quebec, to identify females who had an HDP diagnosis during a birth admission between 2012 and 2021. We analyzed temporal and geographical trends in HDP, as well as temporal trends in adverse outcomes associated with HDP. Results: Among 2 804 473 hospital admissions for birth between 2012 and 2021, the rate of any HDP increased from 6.1% to 8.5%, including pre-existing hypertension (0.6% to 0.9%), gestational hypertension (3.9% to 5.1%), and preeclampsia (1.6% to 2.6%). For 2017-2021 combined, relative to Ontario (6.9%), HDP were significantly more prevalent in nearly all other Canadian regions. For example, in Newfoundland and Labrador, the rate was 10.7% (unadjusted rate ratio 1.56, 95% confidence interval 1.49-1.63). Among females with any HDP, rates of cesarean delivery rose from 42.0% in 2012 to 44.3% in 2021, as did acute renal failure (0.4% to 0.6%), while rates of early preterm delivery, intrauterine fetal death, maternal hospital length of stay ([greater than or equal to] 7 d), admission to the maternal intensive care unit, severe hemorrhage, and SMM trended downward. Interpretation: The rate of HDP has risen across Canada, with a concomitant decline in some HDP-associated morbidities. Ongoing surveillance of HDP is needed to assess the factors associated with temporal trends, including the effectiveness of evolving HDP prevention and management efforts.<br />Hypertensive disorders of pregnancy (HDP) include pre-existing (chronic) hypertension, gestational hypertension, and preeclampsia or eclampsia. Globally, hypertensive disorders affect 5%-10% of pregnancies and are responsible for more than 50 000 [...]
Details
- Language :
- English
- ISSN :
- 08203946
- Volume :
- 196
- Issue :
- 26
- Database :
- Gale General OneFile
- Journal :
- CMAJ: Canadian Medical Association Journal
- Publication Type :
- Periodical
- Accession number :
- edsgcl.803231292
- Full Text :
- https://doi.org/10.1503/cmaj.231547