The effect of elevated blood pressure and stage one hypertension on perinatal outcomes in Appalachian Gravidas: A Retrospective Cohort Study

Authors

• Caroline Briggs, Marshall UniversityFollow
• Austin L. Loop, Marshall UniversityFollow
• Grace E. Montgomery, Marshall UniversityFollow
• David G. Chaffin, Joan C Edawrds School of MedicineFollow
• Jesse Cottrell, Marshall UniversityFollow

Author Credentials

Jesse Cottrell, MD David Chaffin, MD

Author ORCID Identifier

0000-0002-0247-5443

Keywords

pregnancy, hypertension, elevated blood pressure, stage 1 hypertension, Appalachia, low dose aspirin

Disciplines

Medicine and Health Sciences | Obstetrics and Gynecology

Abstract

Introduction:  There is literature in the obstetric population that suggests any degree of hypertension (blood pressures greater than or equal to 120 systolic or 80 diastolic) can lead to adverse maternal and fetal outcomes.  We sought to determine if pregnant patients in our Appalachian population with elevated blood pressure or stage 1 hypertension have an increased risk of gestational hypertension and preeclampsia.

Methods:  A retrospective chart review was performed on patients who received obstetric care with the Marshall University OB/GYN department and delivered at Cabell Huntington Hospital.  Delivery outcomes were obtained for 233 deliveries from March 30, 2020 to September 30, 2020 in patients who did not meet obstetric criteria for chronic hypertension at the initial prenatal visit in the first trimester.  Patients were divided into three groups: normotensive with blood pressurediastolic, elevated blood pressure of 120-129 systolic anddiastolic, or stage 1 hypertension of 130-139 systolic or 80-89 diastolic. Maternal demographics and pregnancy outcomes were compared.

Results:There were 78 normotensive patients, 61 patients with elevated blood pressure, and 94 patients with stage 1 hypertension. There was a significant difference in gestational age at delivery, with stage I hypertension having significantly lower gestational age compared to controls and elevated blood pressure status (p value

Conclusion:  Stage 1 hypertension in the first trimester increases the risk of gestational hypertension, preeclampsia, and early delivery in Appalachian gravidas.  Pregnant patients who do not meet obstetric criteria for chronic hypertension but have elevated blood pressure are at risk for adverse outcomes.  Strategies directed at individuals with elevated blood pressure are needed to improve both maternal and fetal outcomes.

Recommended Citation

Briggs C, Loop AL, Montgomery GE, Chaffin DG, Cottrell J. The effect of elevated blood pressure and stage one hypertension on perinatal outcomes in Appalachian Gravidas: A Retrospective Cohort Study. Marshall J Med. 2026; 12(3) DOI: https://doi.org/10.33470/2379-9536.1395.