Gestational Hypertension in Brazil: maternal mortality analysis and new paradigms (2014–2023)

Abstract

Hypertensive disorders of pregnancy are among the leading causes of maternal mortality in Brazil, particularly preeclampsia and eclampsia, which are severe forms often associated with serious clinical complications. This study aimed to analyze maternal deaths related to these conditions between 2014 and 2023, based on data from the Mortality Information System (SIM/DATASUS). This is a cross-sectional, descriptive, and quantitative study that included records classified under ICD-10 codes O13, O14, and O15, stratified by the timing of death and geographic region. A total of 2,535 maternal deaths were recorded, 72.9% of which occurred during the postpartum period and 49.2% were due to eclampsia. The Northeast and Southeast regions had the highest incidence. The findings highlight the impact of severe forms of the disease while also underscoring the risks associated with isolated gestational hypertension, which may progress to more complex conditions. The high incidence during the postpartum period reveals weaknesses in postnatal care, particularly in areas with limited access to specialized services. It is concluded that reducing maternal mortality from hypertension requires strengthening prenatal and postpartum care networks, ongoing professional training, and improved access to testing and early diagnosis, with particular attention to regional disparities. The implementation of effective public health policies is essential to address this critical challenge.