A groundbreaking study from the University of Cincinnati College of Medicine offers new perspectives on when pregnant women with chronic hypertension should consider delivering their babies.
This research, recently published in O&G Open, suggests that the ideal delivery timing for these women is at 39 weeks of gestation.
Study Background and Findings
Currently, medical guidelines recommend delivery between 37 and 39 weeks, but the backing for these timeframes has been limited.
The researchers broke new ground by tapping into a national patient database, revealing significant advantages tied to delivering babies at 39 weeks.
To arrive at these conclusions, the team analyzed an extensive dataset from the U.S. Centers for Disease Control and Prevention, encompassing nearly 227,000 births documented between 2014 and 2018.
This dataset stands out as the most comprehensive examination of delivery timing for expectant mothers with chronic hypertension, enabling the researchers to draw robust and reliable conclusions.
Significance of the Research
Dr. Robert Rossi, who led the study and serves as an associate professor in the Department of Obstetrics and Gynecology, emphasized the importance of their findings.
By utilizing a wealth of data representing births across the entire United States during this period, the study provides evidence-based recommendations tailored to pregnant women facing chronic hypertension.
Chronic hypertension impacts about 3% to 10% of expectant mothers, a condition that can diminish blood flow to critical organs, including the uterus and placenta.
This reduction can adversely affect fetal development and raises the likelihood of complications, such as preeclampsia, premature delivery, low birth weight, stillbirth, and increased mortality in newborns.
The study’s results indicate that it is beneficial for women with chronic hypertension to aim for delivery at 39 weeks unless other serious medical issues warrant earlier intervention.
By choosing this timing, these women can help mitigate the risks associated with prolonged pregnancy, such as stillbirth, while also considering the potential health risks for infants born earlier.
Demographic Insights and Future Directions
Furthermore, the research highlights a notable pattern among African American women, who are more likely to suffer from chronic hypertension and face higher stillbirth and infant mortality rates.
This demographic also stands to gain from the findings that advocate for a 39-week delivery.
The study estimates that for every 100 women with chronic hypertension who deliver at 39 weeks instead of 40, there’s a potential to prevent at least one case of stillbirth, infant death, or other adverse neonatal outcomes.
These findings underscore the necessity of establishing optimal delivery times, particularly as the prevalence of chronic hypertension during pregnancy continues to climb.
Looking ahead, Dr. Rossi calls for further research to explore the delivery practices for pregnant patients treated with medication for chronic hypertension.
The goal is to determine whether these women should also consider a 39-week delivery or if alternative timing might serve them better.
The research team comprised several distinguished contributors: Ira Hamilton, MD, the lead author now practicing near Toledo; Emily DeFranco, DO, the former director of UC’s Division of Maternal-Fetal Medicine who currently chairs obstetrics and gynecology at the University of Kentucky; James Liu, MD, a former fellow now based in Colorado; and Labeena Wajahat, MD, a recent resident currently practicing in Texas.
Source: ScienceDaily