Prevalence, Incidence, and Temporal Trend of Hypertensive Disorders of Pregnancy and Its Association with Adverse Perinatal Outcomes in High and Low-Middle Income Countries: A Narrative Review
Abstract
Hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complication in both high and low-middle-income countries. The age-standardized incidence rate and the absolute incidence number of HDP in low-middle-income countries are 2-fold and 4-fold higher than in high-income countries in 2021, respectively. However, the reduction in the age-standardized prevalence rate (-41.1% vs. -8.7%) and incidence rate (-40.8% vs. -7.1%) of HDP is ≈5-fold faster in low-middle income countries compared with high-income countries between 1990 and 2021. Moreover, HDP is significantly associated with the increased risk of adverse perinatal outcomes, including preterm birth, low birth weight, and perinatal mortality in both high and low-middle-income countries. In the current review, we have highlighted the prevalence, incidence, and temporal trend of HDP and its association with adverse perinatal outcomes in high and low-middle-income countries.
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24. Zhang J, Zeisler J, Hatch MC, Berkowitz G (1997). Epidemiology of pregnancy-induced hypertension. Epidemiol Rev, 19 (2):218-232.
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26. Chen X-K, Wen SW, Smith G, et al (2007). Pregnancy‐induced hypertension and infant mortality: roles of birthweight centiles and gestational age. BJOG, 114 (1):24-31.
27. Bridwell M, Handzel E, Hynes M, et al (2019). Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection. BMC Pregnancy Childbirth, 19 (1):208.
28. Berhe AK, Ilesanmi AO, Aimakhu CO, et al (2019). Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study. BMC Pregnancy Childbirth, 20 (1):7.
29. Muti M, Tshimanga M, Notion GT, et al (2015). Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC Cardiovasc Disord, 15:111.
30. Rahman LA, Hairi NN, Salleh N (2008). Association between pregnancy induced hypertension and low birth weight; a population based case-control study. Asia Pac J Public Health, 20 (2):152-158.
31. Sibai BM (2006). Preeclampsia as a cause of preterm and late preterm (near-term) births. Semin Perinatol, 30(1):16-9.
32. Li X, Zhang W, Lin J, et al (2018). Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases. J Clin Hypertens (Greenwich), 20 (6):1049-1057.
33. Omani-Samani R, Ranjbaran M, Amini P, et al (2019). Adverse maternal and neonatal outcomes in women with preeclampsia in Iran. J Matern Fetal Neonatal Med, 32 (2):212-216.
34. van Esch JJ, van Heijst AF, de Haan AF, et al (2017). Early-onset preeclampsia is associated with perinatal mortality and severe neonatal morbidity. J Matern Fetal Neonatal Med, 30 (23):2789-2794.
35. Liu C-M, Cheng P-J, Chang S-D (2008). Maternal complications and perinatal outcomes associated with gestational hypertension and severe preeclampsia in Taiwanese women. J Formos Med Assoc, 107 (2):129-138.
36. Tlaye KG, Endalfer ML, Kassaw MW, et al (2020). Preeclampsia management modalities and perinatal death: a retrospective study in Woldia general hospital. BMC Pregnancy Childbirth, 20:205.
2. Duley L (2009). The Global Impact of Pre-eclampsia and Eclampsia. Semin Perinatol, 33 (3):130-137.
3. Say L, Chou D, Gemmill A, et al (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health, 2 (6):e323-e333.
4. Abalos E, Cuesta C, Carroli G, et al (2014). Pre‐eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn H ealth. BJOG, 121 Suppl 1:14-24.
5. Blencowe H, Cousens S, Oestergaard MZ, et al (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet, 379 (9832):2162-2172.
6. Walani SR (2020). Global burden of preterm birth. Int J Gynaecol Obstet, 150 (1):31-33.
7. Chawanpaiboon S, Vogel JP, Moller AB, et al (2019). Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health, 7 (1):e37-e46.
8. Martin J, Osterman M (2018). Describing the increase in preterm births in the United States, 2014-2016. NCHS Data Brief, (312):1-8.
9. Jing S, Chen C, Gan Y, et al (2020). Incidence and trend of preterm birth in China, 1990–2016: a systematic review and meta-analysis. BMJ Open, 10 (12):e039303.
10. Hughes MM., Black, RE, Katz, J (2017). 2500-g Low Birth Weight Cutoff: History and Implications for Future Research and Policy. Matern Child Health J, 21 (2):283–289.
11. World Health Organization (2019). UNICEF-WHO low birthweight estimates: levels and trends 2000-2015. In UNICEF-WHO low birthweight estimates: levels and trends 2000-2015.
12. Ratnasiri AW, Parry SS, Arief VN, et al (2018). Recent trends, risk factors, and disparities in low birth weight in California, 2005–2014: a retrospective study. Matern Health Neonatol Perinatol, 4 :15.
13. Takimoto H, Yokoyama T, Yoshiike N, et al (2005). Increase in low‐birth‐weight infants in Japan and associated risk factors, 1980–2000. J Obstet Gynaecol Res, 31 (4):314-322.
14. Kim HE, Song IG, Chung SH, et al (2019). Trends in birth weight and the incidence of low birth weight and advanced maternal age in Korea between 1993 and 2016. J Korean Med Sci, 34 (4):e34.
15. Rao J, Fan D, Wu S, et al (2018). Trend and risk factors of low birth weight and macrosomia in south China, 2005–2017: a retrospective observational study. Sci Rep, 8 (1):3393.
16. Hug L, Alexander M, You D, et al (2019). National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis. Lancet Glob Health, 7 (6):e710-e720.
17. Ravelli AC, Eskes M, van der Post JA, et al (2020). Decreasing trend in preterm birth and perinatal mortality, do disparities also decline? BMC Public Health, 20:783.
18. Song YH, Lee G-M, Yoon JM, et al (2017). Trends in fetal and perinatal mortality in Korea (2009–2014): Comparison with Japan and the United States. J Korean Med Sci, 32 (8):1319-1326.
19. Hossain MB, Kanti Mistry S, Mohsin M, Rahaman Khan MH (2019). Trends and determinants of perinatal mortality in Bangladesh. PLoS One, 14 (8):e0221503.
20. Salameh K, Rahman S, Al-Rifai H, et al (2009). An analytic study of the trends in perinatal and neonatal mortality rates in the State of Qatar over a 30-year period (1977 to 2007): a comparative study with regional and developed countries. J Perinatol, 29 (11):765-770.
21. Wu QJ, Li LL, Li J, et al (2016). Time trends of neonatal mortality by causes of death in Shenyang, 1997–2014. Oncotarget, 7 (13):16610-8.
22. Wang X, Cheng F, Fu Q, et al (2024). Time trends in maternal hypertensive disorder incidence in Brazil, Russian Federation, India, China, and South Africa (BRICS): an age-period-cohort analysis for the GBD 2021. BMC Pregnancy Childbirth, 24 (1):731.
23. Vollset SE, Ababneh HS, Abate YH, et al (2024). Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021. Lancet, 403 (10440):2204-2256.
24. Zhang J, Zeisler J, Hatch MC, Berkowitz G (1997). Epidemiology of pregnancy-induced hypertension. Epidemiol Rev, 19 (2):218-232.
25. Xiong X, Fraser WD (2004). Impact of pregnancy‐induced hypertension on birthweight by gestational age. Paediatr Perinat Epidemiol, 18 (3):186-191.
26. Chen X-K, Wen SW, Smith G, et al (2007). Pregnancy‐induced hypertension and infant mortality: roles of birthweight centiles and gestational age. BJOG, 114 (1):24-31.
27. Bridwell M, Handzel E, Hynes M, et al (2019). Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection. BMC Pregnancy Childbirth, 19 (1):208.
28. Berhe AK, Ilesanmi AO, Aimakhu CO, et al (2019). Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study. BMC Pregnancy Childbirth, 20 (1):7.
29. Muti M, Tshimanga M, Notion GT, et al (2015). Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC Cardiovasc Disord, 15:111.
30. Rahman LA, Hairi NN, Salleh N (2008). Association between pregnancy induced hypertension and low birth weight; a population based case-control study. Asia Pac J Public Health, 20 (2):152-158.
31. Sibai BM (2006). Preeclampsia as a cause of preterm and late preterm (near-term) births. Semin Perinatol, 30(1):16-9.
32. Li X, Zhang W, Lin J, et al (2018). Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases. J Clin Hypertens (Greenwich), 20 (6):1049-1057.
33. Omani-Samani R, Ranjbaran M, Amini P, et al (2019). Adverse maternal and neonatal outcomes in women with preeclampsia in Iran. J Matern Fetal Neonatal Med, 32 (2):212-216.
34. van Esch JJ, van Heijst AF, de Haan AF, et al (2017). Early-onset preeclampsia is associated with perinatal mortality and severe neonatal morbidity. J Matern Fetal Neonatal Med, 30 (23):2789-2794.
35. Liu C-M, Cheng P-J, Chang S-D (2008). Maternal complications and perinatal outcomes associated with gestational hypertension and severe preeclampsia in Taiwanese women. J Formos Med Assoc, 107 (2):129-138.
36. Tlaye KG, Endalfer ML, Kassaw MW, et al (2020). Preeclampsia management modalities and perinatal death: a retrospective study in Woldia general hospital. BMC Pregnancy Childbirth, 20:205.
| Files | ||
| Issue | Vol 54 No 4 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Hypertensive disorders of pregnancy Prevalence Incidence Adverse perinatal outcomes Socioeconomic status | ||
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How to Cite
1.
Qiang Y, Xiaoli D, . N, Lihua Q. Prevalence, Incidence, and Temporal Trend of Hypertensive Disorders of Pregnancy and Its Association with Adverse Perinatal Outcomes in High and Low-Middle Income Countries: A Narrative Review. Iran J Public Health. 2025;54(4):701-709.
