ObjectiveTo assess maternal and perinatal outcomes of pregnancies in women with chronic hypertension (CH).MethodsRetrospective cohort of women with CH followed at a referral center for a 5 year period (2012–2017). Data were obtained from medical charts review and described as means and frequencies, and a Poisson regression was performed to identify factors independently associated to the occurrence of superimposed pre-eclampsia (sPE).ResultsA total of 385 women were included in the present study; the majority were > than 30 years old, multiparous, mostly white and obese before pregnancy. One third had pre-eclampsia (PE) in a previous pregnancy and 17% of them had organ damage associated with hypertension, mainly kidney dysfunction. A total of 85% of the patients used aspirin and calcium carbonate for pre-eclampsia prophylaxis and our frequency of sPE was 40%, with an early onset (32.98 ± 6.14 weeks). Of those, 40% had severe features of PE, including 5 cases of HELLP syndrome; however, no cases of eclampsia or maternal death were reported. C-section incidence was high, gestational age at birth was 36 weeks, and nearly a third (115 cases) of newborns had complications at birth One third of the women remained using antihypertensive drugs after pregnancy.ConclusionChronic hypertension is related with the high occurrence of PE, C-sections, prematurity and neonatal complications. Close surveillance and multidisciplinary care are important for early diagnosis of complications.