What is the optimal time for delivery in women with gestational hypertension?

Abstract

Objective: To assess the optimal timing of delivery for women with gestational hypertension.

Study design: A multicenter database that contained 228,668 deliveries was used to extract data on gravidas with gestational hypertension. The week-specific rates of maternal and neonatal morbidity/mortality were calculated after induction of labor. Point wise 95% confidence intervals were calculated around each of these gestational age-specific rates.

Results: After induction of labor, the rate of maternal morbidity/mortality reached a nadir of 89.9 per 1000 live births (95% confidence interval, 68.1-111.8) at 38-38 6/7 weeks' gestation, although the rate of neonatal morbidity/mortality fell to 10.5 per 1000 live births (95% confidence interval, 2.8-18.2) at 39-39 6/7 weeks. There were only 3 total stillbirths in our study cohort.

Conclusion: In women with gestational hypertension, induction of labor between 38- and 39-weeks' balances the lowest maternal and neonatal morbidity/mortality.