Temporal trends in hypertensive disorders of pregnancy in British Columbia, Canada.

Publication date: Jul 21, 2026

The rates of hypertensive disorders in pregnancy have been consistently increasing over the past decades. This study investigated temporal trends in hypertensive disorders of pregnancy in British Columbia (BC), Canada. We studied all women who delivered at 20-44 weeks’ gestation in BC, 2012/13-2023/24 (N = 515 778). Data was obtained from the BC Perinatal Database Registry. Conditions of interest included chronic hypertension (CH), gestational hypertension (GH), preeclampsia (PE), PE superimposed on chronic hypertension, preeclampsia with severe features (including eclampsia), and HELLP syndrome. Temporal trends were assessed using logistic regression, and we examined how trends changed after adjusting for maternal risk factors such as age, parity, pre-pregnancy body-mass-index, twin pregnancy, etc. Interrupted time series analyses assessed changes associated with onset of the COVID-19 pandemic. GH increased from 48. 1 per 1000 pregnancies in 2012/13 to 77. 7 per 1000 pregnancies in 2023/24, while PE rose from 17. 6 to 41. 6 per 1000 pregnancies. Increases were also observed in CH, PE superimposed on chronic hypertension, and PE with severe features, though the composite PE with severe features/HELLP rate remained relatively stable. Increasing trends were attenuated but persisted after adjustment for maternal risk factors. A decreasing trend was observed in adjusted odds of HELLP syndrome (Adjusted odds ratio (AOR) 0. 978, 95% CI 0. 964-0. 993 per year). Pandemic onset was associated with small declines in rates of PE and superimposed PE, though increasing trends continued afterwards. The growing burden of HDPs implies an increased need for patient monitoring, prevention strategies, and accurate surveillance of disease severity.

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