<![CDATA[Background: Hypertensive disorders in pregnancy remain a major cause of maternal and perinatal morbidity and mortality, especially when gestational hypertension progresses to pre-eclampsia, eclampsia, stroke, organ dysfunction, fetal growth restriction, or preterm birth. Objective: This review aimed to synthesize recent determinants of hypertensive disorders in pregnancy and organize them into domains that can support antenatal risk screening. Methods: This systematic literature review followed PRISMA 2020 guidance. Searches were conducted in June 2026 through PubMed (n=386), Scopus (n=284), ScienceDirect (n=216), Google Scholar (n=220), and official public-health sources (n=8). The review used a PEO framework: pregnant women, exposure to socio-demographic, clinical-metabolic, pregnancy-placental, behavioral-environmental, or health-system determinants, and occurrence of hypertensive disorders of pregnancy. Articles published mainly from 2022 to 2026 were prioritized; key official documents were retained for epidemiological and guideline context. Quality appraisal used JBI checklists for observational studies, AMSTAR 2 for systematic reviews, and AACODS for official reports. Results: From 1,114 records, 26 sources met eligibility criteria. The most consistent determinants were chronic hypertension, previous pre-eclampsia, high body mass index or obesity, diabetes, kidney disease, nulliparity, advanced maternal age, multiple gestation, and delayed or limited antenatal risk identification. Conclusion: Hypertensive disorders in pregnancy are multifactorial and require integrated antenatal screening that combines biomedical history, obstetric risk, nutrition, environmental context, and access to care.]]>
