Association of Antihypertensive Therapy with Preeclampsia Severity and Magnesium Sulfate Administration: A Comparative Cross-Sectional Study
TL;DR
Antihypertensive therapy was associated with better blood pressure control and lower odds of severe preeclampsia features and MgSO₄ administration and Prospective studies are warranted to confirm these findings.
Abstract
Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Antihypertensive therapy is essential for blood pressure control; however, its association with disease severity and the need for magnesium sulfate (MgSO₄) prophylaxis remains insufficiently characterized. To evaluate the association between antihypertensive therapy, preeclampsia with severe features, and MgSO₄ administration among women with preeclampsia. This comparative cross-sectional study was conducted at Bint Al-Huda Maternity Hospital, Nasiriyah, Iraq, from October 2025 to March 2026. Eighty women with preeclampsia were included and classified according to treatment status into an untreated group (n=40), consisting of newly diagnosed women who had not yet started antihypertensive therapy, and a treated group (n=40), consisting of women who had received antihypertensive therapy for at least 7 days. Preeclampsia severity was classified according to American College of Obstetricians and Gynecologists criteria. Multivariable logistic regression assessed associations with severe features and MgSO₄ administration after adjustment for age, body mass index, gestational age, and history of preeclampsia. Systolic and diastolic blood pressures were significantly lower in the treated group than in the untreated group (150 vs. 160 mmHg, P=0.016; 90 vs. 100 mmHg, P=0.001). MgSO₄ administration was significantly less frequent among treated women (22.5% vs. 45.0%, P=0.033). Severe features were also less frequent in the treated group (32.5% vs. 62.5%, P=0.007). After adjustment, antihypertensive therapy was independently associated with lower odds of severe features (aOR=0.305, 95% CI: 0.111–0.834; P=0.021) and MgSO₄ administration (aOR=0.281, 95% CI: 0.094–0.841; P=0.023).Antihypertensive therapy was associated with better blood pressure control and lower odds of severe preeclampsia features and MgSO₄ administration. Prospective studies are warranted to confirm these findings.