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<p>Evidence on subtype-specific risks of adverse outcomes associated with hypertensive disorders of pregnancy (HDP) remains limited. This study aimed to analyze temporal trends in HDP prevalence and investigate subtype-specific associations with maternal and fetal complications. A retrospective cohort study was conducted using data from 1508 maternity hospitals across mainland China from 2016 to 2019, involving 18,916,671 pregnant individuals aged 15–49 years. Poisson regression models were used to estimate adjusted relative risks (aRRs) for outcomes including maternal morbidity, in-hospital mortality, and fetal complications. The prevalence of HDP increased from 4.92 to 6.48% (<i>P</i> &lt; 0.001). The incidence of superimposed preeclampsia almost tripled, rising from 0.11 to 0.32%. In-hospital maternal mortality associated with HDP decreased from 40.26/100,000 to 16.26/100,000, while HDP-related organ dysfunction, such as heart failure and renal failure, increased from 0.78 to 1.02% and from 0.17 to 0.25%, respectively. Examining subtype-specific outcomes, women with preeclampsia with severe features faced the highest risk for heart failure (aRR 3.01; 95% CI, 2.91–3.10), whereas those with superimposed preeclampsia were more susceptible to renal failure (aRR 28.85; 95% CI, 24.70–33.70). Regarding fetal outcomes, superimposed preeclampsia was associated with the highest risks of preterm birth (aRR 4.85; 95% CI, 4.76–4.94) and stillbirth (aRR 5.09; 95% CI, 4.84–5.35). The prevalence of HDP and its related organ dysfunction increased during the study period. The findings underscore the critical need to address HDP-associated organ injury and to develop tailored management strategies for different HDP subtypes.</p><p></p>

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Prevalence, trends, and subtype-specific outcomes of hypertensive disorders in pregnancy in China: data from 18 million pregnant women in a hospitalization-based retrospective study

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Lian Chen,
  • Huifeng Shi,
  • Yuan Wei,
  • Yuanyuan Wang,
  • Xudong Ma,
  • Jie Qiao,
  • Yangyu Zhao

摘要

Evidence on subtype-specific risks of adverse outcomes associated with hypertensive disorders of pregnancy (HDP) remains limited. This study aimed to analyze temporal trends in HDP prevalence and investigate subtype-specific associations with maternal and fetal complications. A retrospective cohort study was conducted using data from 1508 maternity hospitals across mainland China from 2016 to 2019, involving 18,916,671 pregnant individuals aged 15–49 years. Poisson regression models were used to estimate adjusted relative risks (aRRs) for outcomes including maternal morbidity, in-hospital mortality, and fetal complications. The prevalence of HDP increased from 4.92 to 6.48% (P < 0.001). The incidence of superimposed preeclampsia almost tripled, rising from 0.11 to 0.32%. In-hospital maternal mortality associated with HDP decreased from 40.26/100,000 to 16.26/100,000, while HDP-related organ dysfunction, such as heart failure and renal failure, increased from 0.78 to 1.02% and from 0.17 to 0.25%, respectively. Examining subtype-specific outcomes, women with preeclampsia with severe features faced the highest risk for heart failure (aRR 3.01; 95% CI, 2.91–3.10), whereas those with superimposed preeclampsia were more susceptible to renal failure (aRR 28.85; 95% CI, 24.70–33.70). Regarding fetal outcomes, superimposed preeclampsia was associated with the highest risks of preterm birth (aRR 4.85; 95% CI, 4.76–4.94) and stillbirth (aRR 5.09; 95% CI, 4.84–5.35). The prevalence of HDP and its related organ dysfunction increased during the study period. The findings underscore the critical need to address HDP-associated organ injury and to develop tailored management strategies for different HDP subtypes.