A Case–Control Study of Fetal Outcomes in Hypertensive Disorders of Pregnancy: Insights from a 5-Year Review at a Tertiary Care Health Facility in Nigeria

A bstract Background: Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal mortality globally and are also recognized causes of adverse fetal outcomes. Objectives: We aimed to determine and quantify the risk of adverse fetal outcomes associated with HDP. Materials and Methods: A 5-year retrospective study was conducted at the Delta State University Teaching Hospital from May 2019 to April 2024. Cases included all deliveries that met the criteria for HDP during the study period, whereas controls comprised normotensive mothers without any comorbidities. Data on maternal age, parity, mode of delivery, place of delivery, supervised/unsupervised delivery, birth weight, Apgar score, gestational age, and delivery outcomes were collected. The prevalence and odds ratios of stillbirth, low birth weight (LBW), preterm delivery, and birth asphyxia were determined. Results: Out of 826 deliveries, 134 (16.2%) met the criteria for HDP, whereas 408 (49.4%) were classified as controls. The incidence of stillbirth was significantly higher among women with HDP ( P = 0.0004; AOR = 4.16; 95% CI = 1.89–9.13). Similarly, the incidence of LBW was significantly higher in women with HDP ( P < 0.0001; AOR = 10.19; 95% CI = 6.53–15.92), as was the incidence of preterm delivery ( P < 0.0001; AOR = 4.86; 95% CI = 3.17–7.40). Additionally, the incidence of birth asphyxia was significantly higher in newborns delivered to mothers with HDP ( P < 0.0001; AOR = 3.4; 95% CI = 2.06–5.07). Conclusion: The HDP significantly contributed to the incidence of stillbirths, LBW, preterm deliveries, and birth asphyxia in Delta state, Nigeria.