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A groundbreaking study led by physician researchers at the University of Cincinnati College of Medicine is challenging current delivery guidelines for pregnant women with chronic hypertension, suggesting that 39 weeks of gestation is the most optimal time for delivery. Published recently in O&G Open, the study marks a significant shift in understanding the ideal timing for delivery in hypertensive pregnancies.
While existing guidelines recommend delivery between 37 and 39 weeks for women with chronic hypertension, these recommendations were based on limited data. This new research, which is the largest of its kind to date, used a comprehensive national data set from the U.S. Centers for Disease Control and Prevention (CDC) to show that waiting until 39 weeks is the most beneficial for both mothers and babies.
The study analyzed birth records from 2014 to 2018, covering approximately 227,000 women, providing a large-scale, data-driven foundation for the new findings. “This study has widespread relevance because it utilized a vast and contemporary data set, encompassing all U.S. births during the specified period,” said Dr. Robert Rossi, associate professor in the Department of Obstetrics and Gynecology at the University of Cincinnati and the study’s lead author.
Chronic hypertension, which affects between 3% to 10% of pregnant women, can significantly impact fetal development by reducing blood flow to the uterus and placenta. It increases the risk of complications such as preeclampsia, preterm birth, low birth weight, and stillbirth. Dr. Rossi emphasized that the study’s findings advocate for delivery at 39 weeks for hypertensive pregnancies, balancing the risks of stillbirth with the potential complications associated with early delivery.
The study also showed that this optimal delivery timing holds true for African American women, who face a higher prevalence of chronic hypertension during pregnancy and associated risks. Dr. Rossi highlighted that, based on the findings, for every 100 women with chronic hypertension who deliver at 39 weeks instead of 40 weeks, one stillbirth or infant death could be prevented.
“As chronic hypertension during pregnancy becomes more common, it is vital to refine our delivery timing strategies to improve both maternal and fetal outcomes,” Rossi noted. He also suggested that future research should focus on women treated with medication for chronic hypertension during pregnancy to determine whether they, too, should follow the 39-week guideline or if an earlier delivery might be more beneficial.
This study offers critical insights into maternal-fetal health and may guide future medical practices for pregnant women with chronic hypertension.
For more information, refer to the full study published in O&G Open (2024). DOI: 10.1097/og9.0000000000000050.
