RT Journal Article
SR Electronic
T1 Trends in rate of hypertensive disorders of pregnancy and associated morbidities in Canada: a population-based study (2012–2021)
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E897
OP E904
DO 10.1503/cmaj.231547
VO 196
IS 26
A1 Dzakpasu, Susie
A1 Nelson, Chantal
A1 Darling, Elizabeth K.
A1 Edwards, Wesley
A1 Murphy, Phil A.
A1 Scott, Heather
A1 Van den Hof, Michiel
A1 Ray, Joel G.
A1 
YR 2024
UL http://www.cmaj.ca/content/196/26/E897.abstract
AB Background: Hypertensive disorders of pregnancy (HDP) are a leading cause of severe maternal morbidity (SMM). We sought to explore trends in HDP and related morbidity outcomes in Canada.Methods: In this retrospective population-based study, we used hospital discharge data from Canada, excluding Quebec, to identify females who had an HDP diagnosis during a birth admission between 2012 and 2021. We analyzed temporal and geographical trends in HDP, as well as temporal trends in adverse outcomes associated with HDP.Results: Among 2 804 473 hospital admissions for birth between 2012 and 2021, the rate of any HDP increased from 6.1% to 8.5%, including pre-existing hypertension (0.6% to 0.9%), gestational hypertension (3.9% to 5.1%), and preeclampsia (1.6% to 2.6%). For 2017–2021 combined, relative to Ontario (6.9%), HDP were significantly more prevalent in nearly all other Canadian regions. For example, in Newfoundland and Labrador, the rate was 10.7% (unadjusted rate ratio 1.56, 95% confidence interval 1.49–1.63). Among females with any HDP, rates of cesarean delivery rose from 42.0% in 2012 to 44.3% in 2021, as did acute renal failure (0.4% to 0.6%), while rates of early preterm delivery, intrauterine fetal death, maternal hospital length of stay (≥ 7 d), admission to the maternal intensive care unit, severe hemorrhage, and SMM trended downward.Interpretation: The rate of HDP has risen across Canada, with a concomitant decline in some HDP-associated morbidities. Ongoing surveillance of HDP is needed to assess the factors associated with temporal trends, including the effectiveness of evolving HDP prevention and management efforts.See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.241017