Treatment of hypertension during pregnancy: a cohort of pregnancy episodes from the SIDIAP database, Catalonia, Spain

Abstract

Hipertensió, Agents antihipertensius, Resultat de l'embaràs

Hipertensión, Agentes antihipertensivos, Resultado del embarazo

Hypertension, Antihypertensive agents, Pregnancy outcome

Introduction: Hypertension during pregnancy is oneofthemostfrequentcauses of maternal and fetal morbimortality. Perinatal and maternal death and disability rates have decreased by 30%, but hypertension during pregnancy has increased by approximately 10% in the last 30years. This research aimed to describe the pharmacological treatment and pregnancy outcomes of pregnancies with hypertension. Methods: We carried out an observational cohort study from the Information System for the Development of Research in Primary Care (SIDIAP) database. Pregnancy episodes with hypertension (ICD-10 codes for hypertension, I10–I15 and O10–O16) were identified. Antihypertensives were classified according to the ATC WHO classification: β-blocking agents (BBs), calcium channel blockers (CCBs), agents acting on the renin-angiotensin system (RAS agents), diuretics, and antiadrenergic agents. Exposure was defined for hypertension in pregnancies with ≥2 prescriptions during the pregnancy episode. Descriptive statistics for diagnoses and treatments were calculated. Results: In total, 4,839 pregnancieswithhypertensiondiagnosisformedthestudy cohort. There were 1,944 (40.2%) pregnancies exposed to an antihypertensive medication. There were differences in mother’s age, BMI, and alcohol intake between pregnancies exposed to antihypertensive medications and those not exposed. BBs were the most used (n = 1,160 pregnancy episodes; 59.7%), followed by RAS agents (n = 825, 42.4%), and CCBs were the least used (n = 347, 17.8%). Discussion: Pregnancies involving hypertension were exposed to antihypertensive medications, mostly BBs. We conduct a study focused on RAS agent use during pregnancy and its outcomes in the offspring.

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was conducted with a grant from IDIAPJGol (this study received funding from the eighth call for SIDIAP grants, 2018 (expedient number 4R18/188) and from the Health Department of the Generalitat de Catalunya in the call corresponding to 2021 for the granting of funding of the Strategic Plan for Research and Innovation in Health (PERIS) 2021–2024, modality Research Projects in Primary Care, expedient number SLT21/21/000068.