Are There Characteristics Associated With Hypertension Beyond the Fourth Trimester? [32G]

Abstract

INTRODUCTION: Literature reports women with hypertensive disorders of pregnancy are at threefold increased risk of having hypertension and twofold increased risk of developing cardiovascular disease later in life. We sought to identify characteristics associated with hypertension in the 12 weeks to 24 months postpartum period. METHODS: We performed an IRB approved, retrospective cohort study on postpartum hypertension from deliveries from 07/09 to 07/16. Inclusion criteria were delivery at our institution, presence of a hypertensive disorder of pregnancy, and a documented blood pressure between 12 weeks to 24 months postpartum. Exclusion criteria were discharge home on antihypertensive medication. Postpartum hypertension was defined as a systolic blood pressure ≥-140 or diastolic blood pressure ≥90. Chi-square test was used for categorical and Student T-test was used for continuous variables. RESULTS: 697 women met inclusion and exclusion criteria. Of these women, 245 were identified as having hypertension 12 weeks to 24 months postpartum. Women with hypertension were more likely to be older (p=0.046), have a higher pre-pregnancy BMI (p<0.001), and be multiparous (p=0.002). There was a statistically significant difference in hypertension when comparing the hypertensive disorders of pregnancy (p<0.001). There were no differences amongst other study variables. CONCLUSION: Of the women who delivered at our institution with a hypertensive disorder of pregnancy, 35% had hypertension in the 12 weeks to 24 months postpartum period. Characteristics more likely associated with postpartum hypertension include older age, higher pre-pregnancy BMI, and multiparity. These characteristics may be important to consider when counseling patients on the importance of continued follow up beyond the fourth trimester.