Introduction: Hypertension in pregnancy plays a key role in perinatal morbidity and mortality. This study aims to analyze maternal and perinatal outcomes associated with hypertension in pregnant women.Methods: A prospective longitudinal study was conducted at the University Hospital of Santa Maria, RS, Brazil, involving hypertensive pregnant women admitted for delivery. The results were analyzed using the chi-square test and the Mann-Whitney test.Results: Of the 162 hypertensive pregnant women studied, 61.1% were diagnosed with preeclampsia. Cesarean section was the most frequent mode of delivery (79.6%). Overall, 46.2% of newborns were premature; of these, 23.4% required intensive neonatal care. Preeclampsia and severe preeclampsia were associated with prematurity in 56.2% of cases (p = 0.011) and 75.7% of cases (p = 0.004), respectively. Severe preeclampsia was associated with neonatal complications (45.9%), and no neonatal complications were associated with mild preeclampsia in 78% (p = 0.014) and gestational hypertension in 96% (p = 0.001). Neonatal deaths occurred in 11.1% of cases admitted to the neonatal intensive care unit, corresponding to a neonatal mortality rate of 24 per 1,000 live births.Conclusions: The association of severe preeclampsia with prematurity and adverse perinatal outcomes corroborates the need for care of these laboring women in referral centers with specialized neonatal care.Keywords: Hypertension; pregnancy; pre-eclampsia; perinatal outcome; neonatal complicationsIntroduction: Hypertension in pregnancy plays a key role in perinatal morbidity and mortality. This study aims to analyze maternal and perinatal outcomes associated with hypertension in pregnant women.Methods: A prospective longitudinal study was conducted at the University Hospital of Santa Maria, RS, Brazil, involving hypertensive pregnant women admitted for delivery. The results were analyzed using the chi-square test and the Mann-Whitney test.Results: Of the 162 hypertensive pregnant women studied, 61.1% were diagnosed with preeclampsia. Cesarean section was the most frequent mode of delivery (79.6%). Overall, 46.2% of newborns were premature; of these, 23.4% required intensive neonatal care. Preeclampsia and severe preeclampsia were associated with prematurity in 56.2% of cases (p = 0.011) and 75.7% of cases (p = 0.004), respectively. Severe preeclampsia was associated with neonatal complications (45.9%), and no neonatal complications were associated with mild preeclampsia in 78% (p = 0.014) and gestational hypertension in 96% (p = 0.001). Neonatal deaths occurred in 11.1% of cases admitted to the neonatal intensive care unit, corresponding to a neonatal mortality rate of 24 per 1,000 live births.Conclusions: The association of severe preeclampsia with prematurity and adverse perinatal outcomes corroborates the need for care of these laboring women in referral centers with specialized neonatal care.Keywords: Hypertension; pregnancy; pre-eclampsia; perinatal outcome; neonatal complications