Transient Gestational Hypertension and Its Subsequent Maternal and Perinatal Outcomes

Objective: To describe maternal and perinatal outcomes among pregnant women with transient gestational hypertension (TGH) defined through prolonged in-hospital surveillance.Methods: This retrospective cohort included pregnant women hospitalized at ≥20 weeks of gestation at a referral hospital in Panama between July 1, 2023, and December 31, 2024.Women were included if they had an initial systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, with no subsequent elevated reading during seven days of measurements obtained every four hours; they were then discharged and followed until delivery.The primary outcome was the subsequent development of gestational hypertension or preeclampsia.Results: A total of 20 pregnant women were included; mean age was 31.9 ± 6.3 years, median gestational age at the initial episode was 32.1 weeks (interquartile range (IQR), 27.9-34.2).Five patients (25.0%; 95% confidence interval, 11.2-46.9)subsequently developed a hypertensive disorder: three developed gestational hypertension and two developed preeclampsia, including one with severe features due to a hypertensive crisis.Among those who progressed, the median time to the new diagnosis was 30 days (IQR,(27)(28)(29)(30)(31)(32)(33)(34)(35).Delivery occurred at a median of 38 weeks; there was one preterm delivery, one neonatal intensive care unit admission, and no maternal or perinatal deaths.In exploratory analyses, progression was associated with a higher cesarean delivery rate and lower neonatal birth weight.Conclusions: Even after seven days of in-hospital normotension, one in four pregnant women progressed to TGH.TGH should not be considered benign and requires subsequent surveillance, ideally with out-ofhospital blood pressure measurements.