Hypertensive Disorders and Maternal Health in Pregnancy

Hypertensive disorders complicate approximately 5–10 % of pregnancies worldwide and remain a leading cause of maternal and perinatal morbidity and mortality. They encompass a spectrum from gestational hypertension to preeclampsia and eclampsia, distinguished by the timing of onset and the presence of proteinuria or organ dysfunction. Underlying placental malperfusion and systemic endothelial activation can give rise to raised blood pressure, end‐organ injury and disturbed fetal growth. Key maternal risks include stroke, renal impairment and haemorrhage, while fetal consequences can range from growth restriction and preterm birth to stillbirth. Early identification through regular antenatal blood pressure surveillance, risk stratification and timely interventions—such as low‐dose aspirin prophylaxis and magnesium sulphate for seizure prevention—are central to optimising outcomes. Disparities in access to care, differences in case definitions and variable health‐system capabilities continue to shape the global burden, particularly in low‐ and middle‐income regions.

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Hypertensive Disorders and Maternal Health in Pregnancy publication trend

The graph below shows the total number of articles in hypertensive disorders and maternal health in pregnancy across all publications each year (not limited to Nature Index journals).

Technical terms

Gestational hypertension: New‐onset elevated blood pressure after 20 weeks of gestation without proteinuria or severe features.

Preeclampsia: Development of hypertension after 20 weeks accompanied by proteinuria or maternal organ dysfunction.

Eclampsia: Onset of seizures in a woman with preeclampsia, in the absence of other neurological conditions.

Proteinuria: Excess protein in the urine, often defined as ≥300 mg in a 24-hour specimen, indicating renal involvement.

Superimposed preeclampsia: New or worsened preeclampsia in a woman with chronic hypertension predating pregnancy.

Small for gestational age (SGA): Fetal or neonatal weight below the 10th centile for gestational age, reflecting impaired intrauterine growth.

References

1. Diagnostic properties of differing BP thresholds for adverse pregnancy outcomes in standard-risk nulliparous women: A secondary analysis of SCOPE cohort data. PLOS Medicine (2025).
2. Systematic and meta-analysis of factors associated with preeclampsia and eclampsia in sub-Saharan Africa. PLOS ONE (2020).
3. Hypertensive disorders in pregnancy and stillbirth rates: a facility-based study in China. Bulletin of the World Health Organization (2018).