Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis

The research article concludes that women with chronic hypertension in US studies have an approximately threefold increased risk of delivery before 37 weeks’ gestation, birth weight <2500 g, and neonatal intensive care admission and a fourfold increased risk of perinatal death compared with the US general pregnancy population1. This systematic review and meta-analysis also shows that women with chronic hypertension have a high pooled incidence of superimposed pre-eclampsia and all other pregnancy complications1

Compared with the US general pregnancy population, the incidence of superimposed pre-eclampsia on average across study populations was nearly eightfold higher compared with pre-eclampsia1.

But my concern is that preterm delivery, caesarean sections, low birth weights, neonatal intensive care admissions and perinatal deaths are all complications of pre-ecclampsia alone. And as said above, that in chronic hypertension there is a high incidence of superimposed pre-eclampsia. So we may infer that the lion's share of complications due to chronic hypertension may be due to superimposed pre-eclampsia. In that case, patients with chronic hypertension with super-imposed pre-eclampsia need more attention in the antenatal period. This factor has to be studied in isolation as the meta-analysis has not answered this.