A groundbreaking study led by researchers at the University of Cincinnati College of Medicine is challenging current guidelines on delivery timing for pregnant women with chronic hypertension. Published recently in O&G Open, the study provides new evidence suggesting that 39 weeks of gestation is the optimal time for delivery in these cases.
Current medical recommendations suggest that women with chronic hypertension should deliver between 37 and 39 weeks of pregnancy. However, these guidelines have been based on limited evidence. The new study, which is the first of its kind, draws on a comprehensive dataset to advocate for a more precise delivery timing of 39 weeks.
The Largest Study of Its Kind The research team utilized U.S. Centers for Disease Control and Prevention (CDC) birth records spanning from 2014 to 2018, which included over 227,000 women. This dataset represents the largest study to date that examines delivery timing specifically in pregnant women with chronic hypertension, offering robust, data-driven recommendations for clinical practice.
Dr. Robert Rossi, the corresponding author of the study, and associate professor in the Department of Obstetrics and Gynecology at the University of Cincinnati, highlighted the significance of the findings. “This study has widespread relevance because it used a large-scale dataset that encompassed all births in the U.S. in the given time frame to provide data-driven recommendations for delivery timing among women with chronic hypertension,” said Rossi.
Chronic Hypertension in Pregnancy Chronic hypertension, affecting between 3% to 10% of pregnant women, is a condition that can impact blood flow to the uterus and placenta, which may interfere with fetal growth. The condition is associated with severe complications, including preeclampsia, preterm birth, stillbirth, low birth weight, and infant death after delivery.
Dr. Rossi’s team emphasized that while delivery at 39 weeks provides the best outcomes for women with chronic hypertension, pregnancies should not extend beyond this period unless there are other complicating factors. The research indicates that a delivery at 39 weeks strikes the optimal balance between minimizing the risk of stillbirth from ongoing pregnancy and reducing the likelihood of infant health issues or death associated with early-term birth, defined as before 39 weeks.
Disproportionate Impact on African American Women The study also focused on the disproportionate impact of chronic hypertension in African American women, who are at higher risk for both chronic hypertension during pregnancy and adverse birth outcomes such as stillbirth and infant death. The research found that 39 weeks was similarly the optimal time for delivery in this group, reinforcing the study’s broader implications for public health.
For every 100 women with chronic hypertension who deliver at 39 weeks instead of 40 weeks, the study projects one less stillbirth, infant death, or adverse newborn outcome. This finding underscores the potential life-saving benefits of adjusting delivery guidelines for this high-risk group.
Future Directions for Research Given the rising prevalence of chronic hypertension during pregnancy, the study’s authors stressed the importance of ongoing research to refine these guidelines further. Dr. Rossi noted that future studies should explore the outcomes of women who are medicated for chronic hypertension during pregnancy. It remains unclear whether these women should deliver at 39 weeks or whether an earlier delivery would offer more benefits for this particular group.
The study’s collaborators include primary author Dr. Ira Hamilton, a former UC College of Medicine maternal-fetal medicine fellow; Dr. Emily DeFranco, former director of the UC Division of Maternal-Fetal Medicine; Dr. James Liu, another former UC fellow; and Dr. Labeena Wajahat, a former UC obstetrics and gynecology resident.
Conclusion This study is a significant step forward in understanding the optimal timing for delivery in pregnant women with chronic hypertension. By utilizing a large, national dataset, the researchers provide valuable evidence to guide healthcare providers in making informed decisions that prioritize the health and safety of both mothers and babies. The findings could influence future clinical practices and lead to better outcomes for pregnant women with chronic hypertension, particularly in underserved populations.
You Might Be Interested In:
-
New Children’s Hospital in Cambridge to Pioneer Integrated Care for Physical and Mental Health
-
Differences in Brain Cell Synapses May Explain Vulnerability to Autism and Schizophrenia
-
Elderberry Juice Linked to Improved Metabolic Health and Weight Management
