International Journal of Public Health Volume. 2, No. 1, Tahun 2025 e-ISSN : 3047-5228; dan p-ISSN : 3047-5236; Hal. 64-80 DOI: https://doi.org/10.62951/ijph.v2i1.300 Available online at: https://international.arikesi.or.id/index.php/IJoPH Received: Desember 30, 2024; Revised: Januari 20, 2025; Accepted: Februari 05, 2025; Online Available: Februari 15, 2025; Reproductive Status Affecting the Incidence of Hypertension in Pregnancy at Prof. Dr. Chairuddin P. Lubis Educational Hospital, Medan City Luthfiah Mawar 1 , Rahayu Lubis 2 , Asfriyati 3 , M. Agung Rahmadi 4 , Helsa Nasution 5 1,2,3 Universitas Sumatera Utara 4 Universitas Islam Negeri Syarif Hidayatullah Jakarta 5 Universitas Negeri Padang Email: 1 luthfiahmawar@students.usu.ac.id, 2 rahayu@usu.ac.id, 3 asfriyati@usu.ac.id, 4 m.agung_rahmadi19@mhs.uinjkt.ac.id, 5 helsanasution95@gmail.com Abstrak: Hypertension in pregnancy is one of the leading causes of maternal mortality, with a global prevalence of 5–10% (Khedagi & Bello, 2021). This study aims to analyze the effect of reproductive status —maternal age, gravidity, and parity—on the incidence of hypertension in pregnancy at Prof. Dr. Chairuddin P. Lubis Educational Hospital, Medan. A case-control design was employed with 96 respondents, consisting of 48 cases and 48 controls. Bivariate analysis revealed that pregnant women aged ≥35 years have a 2.839-fold higher risk of developing hypertension compared to those aged <35 years (OR=2.839; 95% CI: 1.123–7.177; p=0.027). First pregnancy (primigravida) increases the risk by 2.742 times compared to multigravida (OR=2.742; 95% CI: 1.047 –7.178; p=0.040), while nulliparous women have a 2.714-fold higher risk compared to those who have given birth (OR=2.714; 95% CI: 1.101–6.693; p=0.030). Multivariate analysis identified maternal age ≥35 years and nulliparity as the most significant predictors (p=0.005). These findings align with studies by Wiranto & Putriningtyas (2021), Hinkosa et al. (2020), and Luo et al. (2020), which confirmed that advanced maternal age and nulliparity increase the risk of pregnancy complications. The novelty of this research lies in integrating all three reproductive status factors as simultaneous predictors of hypertension risk, providing a new perspective compared to previous studies focused on single variables. Based on these findings, early detection and targeted health education for high-risk mothers are strongly recommended. Keywords: hypertension in pregnancy, maternal age, primigravida, nulliparity, reproductive status, risk predictors 1. INTRODUCTION World Health Organization data reports that the global maternal mortality rate in 2020 was 223 deaths per 100,000 live births. This is equal to nearly 800 maternal deaths every day or one maternal death every two minutes (WHO, 2023b). This high maternal mortality rate remains an important public health problem that requires a reduction of 11.6 per cent annually between 2021 and 2030 to achieve the Sustainable Development Goals (SDGs) target of less than 70 deaths per 100,000 live births worldwide to ensure healthy lives and improved well- being for all people at all ages (WHO, 2023a). Indonesia is the fourth country in the Southeast Asian region with the highest maternal mortality rate in 2020 after Timor-Leste, Cambodia and Myanmar, at 173 deaths per 100,000 live births (WHO, 2023b). From 2022 to 2023, the number of maternal deaths in Indonesia was reported to increase from 3,572 deaths to 4,482 deaths (Kemenkes RI, 2024). Almost 75 per cent of all maternal deaths globally are caused by complications during pregnancy and after delivery, especially hypertension in pregnancy, which are preventable (WHO, 2024). Hypertension in pregnancy is estimated to affect 5-10% of pregnancies worldwide and is one of the main causes of maternal mortality that is still increasing (Khedagi & Bello, 2021). Global Burden Disease data states that the incidence of hypertension in pregnancy has