Main Article Content


Hypertensive disorders in pregnancy (HDP) are a significant health concern worldwide and a leading cause of maternal and perinatal morbidity and mortality. Despite numerous studies on the subject, there is a need for a comprehensive and updated systematic review to consolidate the existing evidence and provide a better understanding of the epidemiology, risk factors, pathophysiology, clinical manifestations, management strategies, and outcomes associated with HDP. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough search of electronic databases, including PubMed, MEDLINE, Scholar Indexing Society, Embase, and Cochrane Library, was performed. The search included studies published up to September 2021. Eligibility criteria included articles written in English, involving human subjects, and investigating hypertensive disorders in pregnancy. The initial search yielded a substantial number of articles related to HDP. After applying inclusion and exclusion criteria, a final selection of studies was included in the review. The findings revealed a wide range of factors associated with the development of HDP, including maternal age, pre-pregnancy body mass index, family history of hypertension, and certain lifestyle factors. Additionally, the review explored the impact of HDP on maternal and fetal health, including increased risks of preeclampsia, preterm birth, intrauterine growth restriction, and other adverse outcomes. Hypertensive disorders in pregnancy remain a significant public health concern with potentially severe consequences for both mother and child. Understanding the risk factors and possible interventions is crucial for early detection, prevention, and appropriate management of HDP. This systematic review provides a comprehensive overview of the current knowledge on HDP, which may help guide further research and inform healthcare policies aimed at reducing the burden of this condition.


Hypertensive disorders pregnancy preeclampsia preterm birth systematic review maternal health perinatal morbidity maternal mortality risk factors management

Article Details

How to Cite
Osei Asamoah , D. ., & Teg-Nefaah Tabong , P. . (2023). Hypertensive Disorders During Pregnancy: A Literature Review. Convergence Chronicles, 4(4), 178–188.


  1. Abalos, E., Cuesta, C., Carroli, G., Qureshi, Z., Widmer, M., Vogel, J. P., Souza, J. P., & WHO Multicountry Survey on Maternal. (2014). Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG : An International Journal of Obstetrics and Gynaecology.
  2. Abouzahr, C., & Wardlaw, T. (2004). Maternal Mortality in 2000 : Estimates developed by WHO, UNICEF, UNFPA. Who.
  3. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. (2002). International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics.
  4. Adu-Bonsaffoh, K., Obed, S. A., & Seffah, J. D. (2014). Maternal outcomes of hypertensive disorders in pregnancy at Korle Bu Teaching Hospital, Ghana. International Journal of Gynecology and Obstetrics.
  6. Alanis, M. C., Robinson, C. J., Hulsey, T. C., Ebeling, M., & Johnson, D. D. (2008). Early-onset severe preeclampsia: induction of labor vs elective cesarean delivery and neonatal outcomes. American Journal of Obstetrics and Gynecology.
  7. Asseffaid, N. A., & Demissie, B. W. (2019). Perinatal outcomes of hypertensive disorders in pregnancy at a referral hospital, Southern Ethiopia. PLoS ONE.
  8. Ben-Haroush, A., Yogev, Y., Glickman, H., Kaplan, B., Hod, M., & Bar, J. (2005). Mode of delivery in pregnant women with hypertensive disorders and unfavorable cervix following induction of labor with vaginal application of prostaglandin E2. Acta Obstetricia et Gynecologica Scandinavica.
  9. Berhan, Y. (2016). No Hypertensive Disorder of Pregnancy; No Preeclampsia-eclampsia; No Gestational Hypertension; No Hellp Syndrome. Vascular Disorder of Pregnancy Speaks for All. In Ethiopian journal of health sciences.
  10. Berhe, A. K., Kassa, G. M., Fekadu, G. A., & Muche, A. A. (2018). Prevalence of hypertensive disorders of pregnancy in Ethiopia: A systemic review and meta-analysis. BMC Pregnancy and Childbirth.
  11. Brown, M. A., Hague, W. M., Higgins, J., Lowe, S., McCowan, L., Oats, J., Peek, M. J., Rowan, J. A., & Walters, B. N. J. (2000). The detection, investigation, and management of hypertension in pregnancy: Executive summary. In Australian and New Zealand Journal of Obstetrics and Gynaecology.
  12. Christian, P., Katz, J., Wu, L., Kimbrough-Pradhan, E., Khatry, S. K., LeClerq, S. C., & West, K. P. (2008). Risk factors for pregnancy-related mortality: A prospective study in rural Nepal. Public Health.
  13. Dassah, E. T., Kusi-Mensah, E., Morhe, E. S. K., & Odoi, A. T. (2019). Maternal and perinatal outcomes among women with hypertensive disorders in pregnancy in Kumasi, Ghana. PLoS ONE.
  14. Filippi, V., Chou, D., Ronsmans, C., Graham, W., & Say, L. (2016). Levels and Causes of Maternal Mortality and Morbidity. In Disease Control Priorities, Third Edition (Volume 2): Reproductive, Maternal, Newborn, and Child Health.
  15. Firoz, T., Chou, D., von Dadelszen, P., Agrawal, P., Vanderkruik, R., Tunçalp, O., Magee, L. A., van Den Broek, N., & Say, L. (2013). Measuring maternal health: Focus on maternal morbidity. In Bulletin of the World Health Organization.
  16. Fokom-Domgue, J., & Noubiap, J. J. N. (2015). Diagnosis of hypertensive disorders of pregnancy in sub-Saharan Africa: A poorly assessed but increasingly important issue. In Journal of Clinical Hypertension.
  17. Ghulmiyyah, L., & Sibai, B. (2012). Maternal Mortality From Preeclampsia/Eclampsia. In Seminars in Perinatology.
  18. Goldenberg, R. L., McClure, E. M., MacGuire, E. R., Kamath, B. D., & Jobe, A. H. (2011). Lessons for low-income regions following the reduction in hypertension-related maternal mortality in high-income countries. In International Journal of Gynecology and Obstetrics.
  19. Hamed, H. O., Alsheeha, M. A., Abu-Elhasan, A. M., Abd Elmoniem, A. E., & Kamal, M. M. (2014). Pregnancy outcomes of expectant management of stable mild to moderate chronic hypertension as compared with planned delivery. International Journal of Gynecology and Obstetrics.
  20. Hayman, R. (2004). Hypertension in pregnancy. Current Obstetrics and Gynaecology.
  21. Hutcheon, J. A., Lisonkova, S., & Joseph, K. S. (2011). Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. In Best Practice and Research: Clinical Obstetrics and Gynaecology.
  22. Immink, A., Scherjon, S., Wolterbeek, R., & Steyn, D. W. (2008). Seasonal influence on the admittance of pre-eclampsia patients in Tygerberg hospital. Acta Obstetricia et Gynecologica Scandinavica.
  23. J., T., C., T., A., M., R., O., A., K., & A., H. (2017). All hypertensive disorders of pregnancy increase the risk of future cardiovascular disease. Hypertension.
  24. Kassebaum, N. J., Bertozzi-Villa, A., Coggeshall, M. S., Shackelford, K. A., Steiner, C., Heuton, K. R., Gonzalez-Medina, D., Barber, R., Huynh, C., Dicker, D., Templin, T., Wolock, T. M., Ozgoren, A. A., Abd-Allah, F., Abera, S. F., Abubakar, I., Achoki, T., Adelekan, A., Ademi, Z., … Lozano, R. (2014). Global, regional, and national levels and causes of maternal mortality during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet.
  25. KS, K., D, W., L, S., AM, G., & PFA, V. L. (2006). WHO Analysis of Causes of Maternal Death: A Systematic Review. Lancet.
  26. L., S., M., G., S., A., P., R., V., S., M., T., & J., P. (2016). Asphyxia, neurologic morbidity, and perinatal mortality in early- term and postterm birth. In Pediatrics.
  27. Lawn J. E, Cousens S, Z. J., and The Lancet Neonatal, & Team, S. S. (2005). 4 million neonatal deaths: when?where? why? Lancet.
  28. Li, J., Shao, X., Song, S., Liang, Q., Liu, Y., & Qi, X. (2020). Immediate versus delayed induction of labour in hypertensive disorders of pregnancy: a systematic review and meta-analysis. BMC Pregnancy and Childbirth.
  29. M., W., M., D., A., W., & J., N. (2016). Trends of preeclampsia/eclampsia and maternal and neonatal outcomes among women delivering in addis ababa selected government hospitals, Ethiopia: a retrospective cross-sectional study. The Pan African Medical Journal.
  30. Muti, M., Tshimanga, M., Notion, G. T., Bangure, D., & Chonzi, P. (2015). Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC Cardiovascular Disorders.
  31. Naderi, S., Tsai, S. A., & Khandelwal, A. (2017). Hypertensive Disorders of Pregnancy. In Current Atherosclerosis Reports.
  32. Ngwenya, S. (2017). Severe preeclampsia and eclampsia: Incidence, complications, and perinatal outcomes at a low-resource setting, mpilo central hospital, bulawayo, Zimbabwe. International Journal of Women’s Health.
  33. Noubiap, J. J., Bigna, J. J., Nyaga, U. F., Jingi, A. M., Kaze, A. D., Nansseu, J. R., & Fokom Domgue, J. (2019). The burden of hypertensive disorders of pregnancy in Africa: A systematic review and meta-analysis. In Journal of Clinical Hypertension.
  34. Nour, N. M. (2008). An introduction to maternal mortality. Reviews in Obstetrics & Gynecology.
  35. N.T.N., N., M., M., H., A.-A., G., C., M., P., N., Z., L., C., M.M., A., G.J., H., M., M., & O., L. (2006). Causes of stillbirths and early neonatal deaths: Data from 7993 pregnancies in six developing countries. In Bulletin of the World Health Organization.
  36. Owiredu, W., Ahenkorah, L., Amidu, N., Turpin, C., & Laing, E. (2010). Seasonal Variation in the Occurrence of Pregnancy-Induced Hypertension - A Ghanaian Study. Journal of the Ghana Science Association.
  37. Owiredu W.K.B.A., Ahenkorah L., Turpin C.A., L. E. F. and A. N. (2009). Putative risk factors of pregnancy-induced hypertension among Ghanaian pregnant women. Journal of Medical and Biomedical Sciences.
  38. Pacher, J., Brix, E., & Lehner, R. (2014). The mode of delivery in patients with preeclampsia at term subject to elective or emergency Cesarean section. Archives of Gynecology and Obstetrics.
  39. Phillips, J. K., Bernstein, I. M., Mongeon, J. A., & Badger, G. J. (2004). Seasonal variation in preeclampsia based on timing of conception. Obstetrics and Gynecology.
  40. Saxena, N., Bava, A., & Nandanwar, Y. (2016). Maternal and perinatal outcome in severe preeclampsia and eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology.
  41. Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A. B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health.
  42. Souza, J. P., Gülmezoglu, A. M., Carroli, G., Lumbiganon, P., & Qureshi, Z. (2011). The world health organization multicountry survey on maternal and newborn health: Study protocol. BMC Health Services Research.
  43. Subramaniam, V. (2007). Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Women’s Health.
  44. Susannah, B., Leisher, H., Lawn, J. E., Kinney, M. V, Kuo, N. T., & Bernis, L. De. (2016). Stillbirths : Investment in ending preventable stillbirths by 2030 will yield multiple returns and help achieve multiple Sustainable Development Goals. The Lancet.
  45. Umesawa, M., & Kobashi, G. (2017). Epidemiology of hypertensive disorders in pregnancy: Prevalence, risk factors, predictors and prognosis. In Hypertension Research.
  46. von Dadelszen, P., & Magee, L. A. (2016). Preventing deaths due to the hypertensive disorders of pregnancy. In Best Practice and Research: Clinical Obstetrics and Gynaecology.
  47. Wagner, L. K. (2004). Diagnosis and management of preeclampsia. In American Family Physician.
  48. World health organization. (2006). Neonatal and perinatal mortality : Country, Regional and Global Estimates. World Health Organisation.
  49. Xenakis, E. M. J., Piper, J. M., Field, N., Conway, D., & Langer, O. (1997). Preeclampsia: Is induction of labor more successful? Obstetrics and Gynecology.
  50. Ying, W., Catov, J. M., Ouyang, P., & Hopkins, J. (2018). Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk Classification and Epidemiology of HDP. J Am Heart Assoc.
  51. Zeeman, G. G., Cipolla, M. J., & Cunningham, F. G. (2009). Cerebrovascular ( Patho ) Physiology i n Preeclampsia / Eclampsia. In Chesley´s hypertensive disorders in pregnancy.