The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

doi:10.3390/jcm11123420

Review

. 2022 Jun 14;11(12):3420.

doi: 10.3390/jcm11123420.

The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

Elisa Longhitano^{1

2}, Rossella Siligato^{1

3}, Massimo Torreggiani¹, Rossella Attini⁴, Bianca Masturzo⁵, Viola Casula⁴, Ida Matarazzo^{1

6}, Gianfranca Cabiddu⁷, Domenico Santoro², Elisabetta Versino^{8

9}, Giorgina Barbara Piccoli¹

Affiliations

¹ Néphrologie et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France.
² Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, A.O.U. "G. Martino", University of Messina, 98125 Messina, Italy.
³ Unit of Nephrology, Azienda Ospedaliera Universitaria Sant'Anna, 44124 Ferrara, Italy.
⁴ Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, University of Torino, 10126 Torino, Italy.
⁵ Department of Obstetrics and Gynaecology, Ospedale Degli Infermi, 13875 Biella, Italy.
⁶ Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
⁷ Nephrology, Azienda Ospedaliera Brotzu, 09047 Cagliari, Italy.
⁸ Department of Clinical and Biological Sciences, University of Torino, 10064 Torino, Italy.
⁹ University Centre of Biostatistics, Epidemiology and Public Health, University of Torino, 10064 Torino, Italy.

PMID: 35743489
PMCID: PMC9225655
DOI: 10.3390/jcm11123420

Review

The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

Elisa Longhitano et al. J Clin Med. 2022.

. 2022 Jun 14;11(12):3420.

doi: 10.3390/jcm11123420.

Authors

Affiliations

¹ Néphrologie et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France.
² Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, A.O.U. "G. Martino", University of Messina, 98125 Messina, Italy.
³ Unit of Nephrology, Azienda Ospedaliera Universitaria Sant'Anna, 44124 Ferrara, Italy.
⁴ Department of Obstetrics and Gynecology, Città della Salute e della Scienza, Ospedale Sant'Anna, University of Torino, 10126 Torino, Italy.
⁵ Department of Obstetrics and Gynaecology, Ospedale Degli Infermi, 13875 Biella, Italy.
⁶ Unit of Nephrology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
⁷ Nephrology, Azienda Ospedaliera Brotzu, 09047 Cagliari, Italy.
⁸ Department of Clinical and Biological Sciences, University of Torino, 10064 Torino, Italy.
⁹ University Centre of Biostatistics, Epidemiology and Public Health, University of Torino, 10064 Torino, Italy.

PMID: 35743489
PMCID: PMC9225655
DOI: 10.3390/jcm11123420

Abstract

About 5-10% of pregnancies are complicated by one of the hypertensive disorders of pregnancy. The women who experience these disorders have a greater risk of having or developing kidney diseases than women with normotensive pregnancies. While international guidelines do not provide clear indications for a nephrology work-up after pregnancy, this is increasingly being advised by nephrology societies. The definitions of the hypertensive disorders of pregnancy have changed greatly in recent years. The objective of this short review is to gather and comment upon the main definitions of the hypertensive disorders of pregnancy as a support for nephrologists, who are increasingly involved in the short- and long-term management of women with these disorders.

Keywords: chronic kidney disease; hypertension; preeclampsia; pregnancy; small for gestational age.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Features of preeclampsia, according to international guidelines.

**Figure 2**
The hypothesis of distinct disorders that may merge into one another.

**Figure 3**
The “sequential hypothesis” of a continuum of severity of the hypertensive disorders of pregnancy.

See this image and copyright information in PMC

Cited by

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Pregnancy on short daily home hemodialysis using low flow dialysate. A narrative review of the literature and a new case report.
Clause AL, Dethier P, Piccoli GB, Gambino G. Clause AL, et al. J Nephrol. 2025 Apr;38(3):913-923. doi: 10.1007/s40620-025-02265-x. Epub 2025 Apr 11. J Nephrol. 2025. PMID: 40214938 Review.
Kidney health outcomes of hypertensive disorders of pregnancy.
Piccoli GB, Torreggiani M, Schwotzer N, Cabiddu G, Attini R, Orozco A, Shemies R, Jesudason S, Fakhouri F, Garovic VD. Piccoli GB, et al. Nat Rev Nephrol. 2025 Jul 18. doi: 10.1038/s41581-025-00977-8. Online ahead of print. Nat Rev Nephrol. 2025. PMID: 40681847 Review.
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Qin Y, Bily D, Aguirre M, Zhang K, Xie L. Qin Y, et al. Nutrients. 2023 May 25;15(11):2459. doi: 10.3390/nu15112459. Nutrients. 2023. PMID: 37299422 Free PMC article. Review.

References

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1. Khosla K., Heimberger S., Nieman K.M., Tung A., Shahul S., Staff A.C., Rana S. Long-Term Cardiovascular Disease Risk in Women After Hypertensive Disorders of Pregnancy: Recent Advances in Hypertension. Hypertension. 2021;78:927–935. doi: 10.1161/HYPERTENSIONAHA.121.16506. - DOI - PMC - PubMed
1. Wang W., Xie X., Yuan T., Wang Y., Zhao F., Zhou Z., Zhang H. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: A population-based study. BMC Pregnancy Childbirth. 2021;21:364. doi: 10.1186/s12884-021-03809-2. - DOI - PMC - PubMed
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1. Ganchimeg T., Mori R., Ota E., Koyanagi A., Gilmour S., Shibuya K., Torloni M.R., Betran A.P., Seuc A., Vogel J., et al. Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: A multi-country study. J. Obstet. Gynaecol. 2013;120:1622–1630. doi: 10.1111/1471-0528.12391. discussion 1630. - DOI - PubMed

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[1] Barrett P.M., McCarthy F.P., Kublickiene K., Cormican S., Judge C., Evans M., Kublickas M., Perry I.J., Stenvinkel P., Khashan A.S. Adverse Pregnancy Outcomes and Long-Term Maternal Kidney Disease: A Systematic Review and Meta-Analysis. JAMA Netw. Open. 2020;3:e1920964. doi: 10.1001/jamanetworkopen.2019.20964. - DOI - PubMed

[2] Barrett P.M., McCarthy F.P., Kublickiene K., Cormican S., Judge C., Evans M., Kublickas M., Perry I.J., Stenvinkel P., Khashan A.S. Adverse Pregnancy Outcomes and Long-Term Maternal Kidney Disease: A Systematic Review and Meta-Analysis. JAMA Netw. Open. 2020;3:e1920964. doi: 10.1001/jamanetworkopen.2019.20964. - DOI - PubMed

[3] Khosla K., Heimberger S., Nieman K.M., Tung A., Shahul S., Staff A.C., Rana S. Long-Term Cardiovascular Disease Risk in Women After Hypertensive Disorders of Pregnancy: Recent Advances in Hypertension. Hypertension. 2021;78:927–935. doi: 10.1161/HYPERTENSIONAHA.121.16506. - DOI - PMC - PubMed

[4] Khosla K., Heimberger S., Nieman K.M., Tung A., Shahul S., Staff A.C., Rana S. Long-Term Cardiovascular Disease Risk in Women After Hypertensive Disorders of Pregnancy: Recent Advances in Hypertension. Hypertension. 2021;78:927–935. doi: 10.1161/HYPERTENSIONAHA.121.16506. - DOI - PMC - PubMed

[5] Wang W., Xie X., Yuan T., Wang Y., Zhao F., Zhou Z., Zhang H. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: A population-based study. BMC Pregnancy Childbirth. 2021;21:364. doi: 10.1186/s12884-021-03809-2. - DOI - PMC - PubMed

[6] Wang W., Xie X., Yuan T., Wang Y., Zhao F., Zhou Z., Zhang H. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: A population-based study. BMC Pregnancy Childbirth. 2021;21:364. doi: 10.1186/s12884-021-03809-2. - DOI - PMC - PubMed

[7] Macedo T.C.C., Montagna E., Trevisan C.M., Zaia V., de Oliveira R., Barbosa C.P., Lagana A.S., Bianco B. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020;248:177–186. doi: 10.1016/j.ejogrb.2020.03.043. - DOI - PubMed

[8] Macedo T.C.C., Montagna E., Trevisan C.M., Zaia V., de Oliveira R., Barbosa C.P., Lagana A.S., Bianco B. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020;248:177–186. doi: 10.1016/j.ejogrb.2020.03.043. - DOI - PubMed

[9] Ganchimeg T., Mori R., Ota E., Koyanagi A., Gilmour S., Shibuya K., Torloni M.R., Betran A.P., Seuc A., Vogel J., et al. Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: A multi-country study. J. Obstet. Gynaecol. 2013;120:1622–1630. doi: 10.1111/1471-0528.12391. discussion 1630. - DOI - PubMed

[10] Ganchimeg T., Mori R., Ota E., Koyanagi A., Gilmour S., Shibuya K., Torloni M.R., Betran A.P., Seuc A., Vogel J., et al. Maternal and perinatal outcomes among nulliparous adolescents in low- and middle-income countries: A multi-country study. J. Obstet. Gynaecol. 2013;120:1622–1630. doi: 10.1111/1471-0528.12391. discussion 1630. - DOI - PubMed

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The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

Affiliations

The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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Abstract

Conflict of interest statement

Figures

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References

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