Abstract
OBJECTIVE: Primary aldosteronism (PA) is a common cause of hypertension in young women. However, there is a paucity of data regarding its impact during pregnancy. The primary objective of this study was to describe the occurrence of hypertensive disorders of pregnancy (HDP) in PA. DESIGN: This retrospective cohort study compared outcomes in pregnancies according to PA status. PATIENTS: Pregnancies occurred between 2011 and 2022 at the Centre Hospitalier Universitaire de Sherbrooke. All selected pregnancies were screened for PA with an aldosterone-to-renin ratio (ARR) within a 5-year period. Pregnancies with more than two fetuses and with other endocrinopathies were excluded. MEASUREMENTS: To ascertain PA diagnosis, ARR measurements were conducted, followed by a confirmatory test if abnormal. RESULTS: Among 226 studied pregnancies, 15 (6.6%) were diagnosed with PA. In the PA group, pre-eclampsia was diagnosed in 46.7% of pregnancies (vs. 30.8%, p = 0.252), while gestational hypertension was diagnosed in 0.0% of pregnancies (vs. 16.6%, p = 0.136). Post-partum HDP occurred in 40.0% of pregnancies with PA (vs 19.4%, p = 0.093). Additionally, 40.0% and 13.3% of pregnancies with PA respectively required intravenous antihypertensive treatment (vs. 24.2%, p = 0.216) and intensive care admission (vs. 3.3%, p = 0.113). CONCLUSIONS: A trend towards an increased incidence of postpartum and severe pre-eclampsia was noted in the PA group.