Epidemiology, risk factors and prevalence of maternal and neonatal outcomes with critical care requirements in hypertensive disorders of pregnancy: a prospective observational study

Background: Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal and neonatal morbidity and mortality worldwide. This study examined maternal and neonatal outcomes across the different HDP subtypes and identified factors linked to ICU and NICU admission. Methods: In this prospective observational analytical study, 144 pregnant women diagnosed with gestational hypertension, non-severe pre-eclampsia, severe pre-eclampsia, eclampsia, chronic hypertension, or superimposed pre-eclampsia (as defined by FOGSI guidelines) were enrolled. Maternal characteristics, maternal complications, ICU admission, neonatal complications, NICU admission, and mortality were recorded from hospital records. Data were analyzed using the Chi-square test, Fisher’s Exact test, multivariate logistic regression, odds ratio estimation, and ROC curve analysis. Results: Severe pre-eclampsia and superimposed pre-eclampsia emerged as independent predictors of maternal ICU admission, while eclampsia and superimposed pre-eclampsia independently predicted NICU admission. Maternal ICU admission was strongly linked to neonatal NICU admission (χ2=13.09, p<0.001). The predictive model performed well, with an AUC of 0.8789, sensitivity of 83.6%, and specificity of 85.7%. Conclusions: Severe HDP subtypes carry a substantially higher risk of adverse maternal and neonatal outcomes. Early recognition, close monitoring, and timely intervention remain central to improving prognosis in hypertensive pregnancies.