Hypertension and Pregnancy: Pharmacologic Treatment and Pregnancy Outcomes

Speaker(s)

Gómez-Lumbreras A1, Vilaplana C2, Leston Vazquez M3, Vedia C4, Giner-Soriano M2, Morros R2
1Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA, 2Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain, 3Institut Catala de Salut, Cataluna, Spain, 4Institut Catala de Salut, Mataró-Maresme, Spain

Presentation Documents

OBJECTIVES: to describe the pharmacological treatment and pregnancy outcomes of pregnant women with hypertension (HTN).

METHODS: observational cohort study from the Information System for the Development of Research in Primary Care (SIDIAP). A previous algorithm was used to identified pregnancy episodes (N=327,865). ICD-10th HTN diagnosis codes (I10-I15 and, gestational HTN O10-O16) were selected. Antihypertensive medications were classified according to the ATC-WHO classification in diuretics, β-blocking agents, calcium-channel blockers, agents acting on the renin-angiotensin system (RAS agents) and other antihypertensives. Descriptive statistics for diagnoses and treatments were calculated. A regression model for prematurity (pregnancy duration of less than 37 weeks) was run.

RESULTS: A total of 4,839 (1.5%) pregnancies with HTN diagnosis were included in the cohort, being 1,861 (38.5%) new diagnoses recorded during the pregnancy episodes. Almost half of the pregnancies were exposed to antihypertensive medications (2,265, 46.8%); of those 1,333 (58.9%) were exposed to only to one group of antihypertensive medications. Half of the pregnancies with previous HTN were exposed to antihypertensives (1,541, 51.7%), mostly β-blocking agents (844, 54.8%) and, diuretics the less (245, 15.9%). Less than half (724, 38.9%) of the gestational HTN pregnancies were expose and the most used were β-blocking agents (528, 34.3%). There were a total of 886 miscarriages (18.3%) and, 687 (17.6%) of the livebirths were preterm (end of pregnancy <37 gestational week). A non-adjusted risk ratio of 1.42 (1.24 to 1.63) was estimated for HTN medication exposure and preterm pregnancy.

CONCLUSIONS: In SIDIAP half of pregnancies with HTN were exposed to HTN medications. β-blocking agents were the most used. Abortions rates were similar to those nationally described. Treated pregnancies were associated to preterm births, though indication bias cannot be rule out. We plan to conduct a study focus on the RAS agents use during pregnancy and its outcomes in the offspring.

Code

HSD83

Topic

Study Approaches

Topic Subcategory

Electronic Medical & Health Records

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Drugs