"Hypertensive Disorders in Pregnancy (HDP) are leading causes of immediate and
long-term maternal and fetal morbidity and early mortality. While a generation
ago these conditions affected 6-8% of all pregnancies, in recent years about one
in eight pregnant women are affected, a rate that translates into more than onehalf
million new cases each year in North America alone. This article discusses
the history, presentations and changing incidence rates of HDP. In addition, it
identifies and describes the social and biological changes that account for the
increases. For example, because risks for developing HDP increase with
advanced maternal age, nulliparity, and multiple gestations, modern trends such
as delayed childbearing, smaller family size, and in vitro fertilization procedures
that increase multi-gestational pregnancies all contribute to the growing
incidence of HDP. Rising levels of obesity evidenced by high-pre-pregnancy body
mass index and metabolic abnormalities also add to the HDP epidemic. The
article concludes with some recommendations regarding how this knowledge can
impact healthcare in the 21st century."
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