Maternal chronic hypertension is associated with increased odds of critical congenital heart disease (CCHD), according to study results presented at the American Heart Association (AHA) Scientific Sessions 2026, held in Chicago, Illinois, from November 6 to 9, 2026.
Maternal hypertensive disorders were categorized as no hypertension, gestational hypertension, chronic hypertension, chronic hypertension plus gestational hypertension, and eclampsia.
The prevalence of CCHD increased modestly from 5.8 per 10,000 births in 2018 to 6.4 per 10,000 births in 2023–2024.
The predicted absolute risk for CCHD increased from 6.3 per 10,000 births among mothers without hypertension to 8.2 per 10,000 births among mothers with chronic hypertension.
Overall, approximately 1.5% of cases of CCHD were attributable to maternal chronic or gestational hypertension.
Maternal chronic hypertension is associated with increased odds of critical congenital heart disease (CCHD), according to study results presented at the American Heart Association (AHA) Scientific Sessions 2026, held in Chicago, Illinois, from November 6 to 9, 2026.
The association between maternal hypertensive disorders and CCHD has not been clearly defined. To examine this association, researchers conducted a population-based study using United States national natality files from 2018 to 2024. More than 40 million live births were classified according to the presence or absence of CCHD. Maternal hypertensive disorders were categorized as no hypertension, gestational hypertension, chronic hypertension, chronic hypertension plus gestational hypertension, and eclampsia.
During the study period, a total of 27,764 cases of CCHD occurred, corresponding to an overall prevalence of 6.3 per 10,000 births.
In this large national cohort, chronic hypertension during pregnancy was independently associated with increased risk of CCHD, whereas gestational hypertension showed a weaker association.
The prevalence of CCHD increased modestly from 5.8 per 10,000 births in 2018 to 6.4 per 10,000 births in 2023–2024. Similarly, the prevalence of hypertensive disorders in pregnancy increased from 9.4% in 2018 to 13.9% in 2024, driven primarily by chronic hypertension.
After adjusting for potential confounders, prepregnancy diabetes (adjusted odds ratio [aOR], 1.48; 95% CI, 1.33-1.64) and chronic hypertension (aOR, 1.30; 95% CI, 1.14-1.48) were associated with increased odds of CCHD. Gestational hypertension showed a weaker, borderline association (aOR, 1.08; 95% CI, 0.99-1.18).
The predicted absolute risk for CCHD increased from 6.3 per 10,000 births among mothers without hypertension to 8.2 per 10,000 births among mothers with chronic hypertension. Overall, approximately 1.5% of cases of CCHD were attributable to maternal chronic or gestational hypertension.
Sensitivity analyses excluding pregnancies with diabetes and restricting the analysis to term births yielded directionally consistent results.
The study authors concluded, “In this large national cohort, chronic hypertension during pregnancy was independently associated with increased risk of CCHD, whereas gestational hypertension showed a weaker association.”
