Abstract
Objectives: To characterize clinical profiles of mothers and neonates in Puerto Rico affected by hypertensive disorders of pregnancy and evaluate associated maternal and neonatal outcomes. Methods: We performed a retrospective review of patients seen at the high-risk clinic of the University District Hospital in Puerto Rico (2020–2023). Patients were excluded if they did not deliver a live infant or
delivered at an outside hospital. Clinical and demographic data were extracted from medical records and grouped by hypertensive status. Descriptive statistics summarized maternal history, delivery outcomes, and neonatal data. Associations were analyzed using Chi-square, Fisher’s exact test, and Wilcoxon-Mann-Whitney tests, with significance set at P ≤ 0.05. Results: Among 278 mothers, 40.3% (n = 112) had a hypertensive disorder, including chronic hypertension (40%) and preeclampsia (22%). Higher maternal BMI was significantly associated with all hypertensive disorders. Chronic hypertension was strongly associated with preeclampsia, conferring 4.8-fold higher odds (95% CI: 2.36–9.75). Hypertensive disorders were linked to earlier gestational age at delivery but not to increased cesarean delivery rates. Neonates of affected mothers had lower Apgar scores. Conclusion: Hypertensive disorders were common and associated with higher BMI, increased risk of preeclampsia among patients with chronic hypertension, earlier delivery, and lower neonatal Apgar scores. These findings highlight the need for early identification, targeted management, and strengthened prenatal screening to reduce hypertension-related complications in high-risk populations in Puerto Rico.