The Prevalence and Significance of Hypertensive Disease in Pregnant Black Women

Objectives: To determine the prevalence and complications of hypertensive disease in pregnant Black women.

Methods: Cross-sectional study. Obstetric records of 1455 Black women who delivered at a tertiary care and teaching center were reviewed for the presence of diastolic blood pressure readings of 90 mm Hg or more. Hypertension was categorized according to the guidelines laid down by the American Association of Obstetricians and Gynecologists. It was stated whether the hypertension was mild (diastolic blood pressure 90-109) or severe (diastolic blood pressure 110 mm Hg).

Main Outcome Measures: Prevalence and severity of hypertension, categories of hypertension, neonatal outcome, and complications of pregnancy.

Results: Hypertension was present in 225 patients (23%) during the antenatal period. Preeclampsia occurred in 1.7%, chronic hypertension in 1.8%, superimposed preeclampsia in 1.5%, transient hypertension in 3%, unclassified hypertension in 6.2%, and unclassified proteinuric hypertension in 8.7%. The perinatal mortality rate was 231 per 1000 deliveries (birth weight 1000 g and more) in patients with severe hypertension and 271 per 1000 in patients with severe proteinuric hypertension.

Conclusions: The prevalence of hypertensive disease in Black pregnant women was 23%, higher than the generally quoted range of 7% to 10%. This was largely attributed to an increased prevalence of chronic hypertension in the Black population.