Prevalence of hypertensive disorders during pregnancy and post-partum in France

Introduction Hypertensive disorders are one of the leading causes of maternal mortality and are also associated with significant cardiovascular and renal morbidity. However very few studies have evaluated the prevalence of different hypertensive disorders of pregnancy and postpartum in France. Purpose The aim of this nationwide study was to estimate the prevalence of hypertensives disorders during the pregnancy and the post-partum. Methods All women with a delivery after 22 weeks of amenorrhea between 2010 and 2016 were selected using data from the national hospital discharge database (PMSI-MCO) integrated into the national health data system (SNDS). In these women, chronic hypertension (persisting or not during pregnancy) in the year preceding pregnancy, gestational hypertension (occurring after 20 weeks of amenorrhea) and preeclampsia/eclampsia were recorded using different algorithms taking into account hospital diagnosis, antihypertensive treatment deliveries and differential diagnosis. Results Between 2010 and 2016, 4,991,308 deliveries occurred in France corresponding to 3,786,510 women. A total of 7.8% of all pregnancies were associated with at least one hypertensive disorder. Chronic hypertension occurred in the year preceding 1.7% of pregnancies and persisted in 1.1% of cases. Gestational hypertension was recorded in 5.2% of pregnancies and Preeclampsia/Eclampsia in 2% of pregnancies. Preeclampsia occurred before 32 weeks of amenorrhea in 17% of cases, between 32 weeks and delivery in 61% of cases and after delivery in 22% of cases. Preeclampsia was not preceded by any other hypertensive disorder in 44.1% of pregnancies. In 11.6% and 44.3% of pregnancies, preeclampsia was preceded by chronic hypertension and by gestational hypertension respectively. Conclusion Hypertensive disorders affected 7.8% of pregnancies in France between 2010 and 2016. It is necessary to pay particular attention to these women in assessing their future cardio-vascular risk.