Objective: The study aimed to determine the prevalence of hypertensive disorders of pregnancy and determinants of its maternal and neonatal outcomes among pregnant mothers admitted to maternity wards of Woliso Saint Luke hospital, Ethiopia.

Materials and Methods: Retrospective, institution-based cross-sectional study was conducted by reviewing records of pregnant mothers admitted to the maternity ward of the hospital between January 01, 2018, and December 31, 2020. The data were extracted using a structured checklist and analyzed using SPSS v. 24. Descriptive statistics of findings, univariate and multivariate logistic regression analysis were performed to identify the independent effect of predictor variables on the maternal and perinatal clinical outcomes.

Results: During a three-year period, 15,097 pregnant mothers were admitted to the hospital's maternity ward. The prevalence of hypertensive disorders of pregnancy was 197(1.3%); more than half 121(61%) attributed to preeclampsia. From the total cases 37(18.8%) of mothers encountered adverse pregnancy outcomes of which 5(2.5%) of them died of its complications. Over half (51.8%) of neonates encountered adverse pregnancy outcomes; 17(20%) were born extremely LBW and 32(16.2%) died. Mothers who had blood pressure level of Ë‚ 160/110 mmHg during admission were 63% less likely to have adverse maternal outcomes compared to higher levels (AOR = 0.37, 95% CI = 0.14-0.94). The earlier gestational age at admission for hypertensive disorder associated to higher odd of adverse pregnancy outcome of neonates (AOR = 18.272, 95% CI = 6.330-52.742).

Conclusion: The magnitude of hypertensive disorders of pregnancy showed significant rate. Besides, the complications or adverse pregnancy outcomes were higher compared to other previous studies. Earlier diagnosis during gestation, prompt management of complications and effective antenatal care are crucial in minimizing adverse outcomes for both mothers and newborns. Provision of focused and better quality care for high-risk mothers from pregnancy to post-partum period is highly recommended.