Clinical features and antenatal risk factors for postpartum-onset hypertensive disorders

Abstract

Careful monitoring of blood pressure should be considered for women with the identified risk factors even after delivery.

Labor therapeutics and BMI as risk factors for postpartum preeclampsia: A case-control study

“…Our results are broadly consistent with those of prior investigations [11, 13]. Using a retrospective case-control study with 34 cases and 68 controls and the same definition of PPPE as our study, Bigelow et al identified BMI at delivery, age >40 years, a diagnosis of gestational diabetes in the index pregnancy, Black race and Latino ethnicity as risk factors [11].…”

“…In a recent retrospective study performed in Japan [13], Takaoka et al also examined demographic risk factors for PPPE, defined as the onset of hypertension after a normotensive pregnancy, after delivery, including cases occurring within the first 48h postpartum. In this study, pre-pregnancy BMI above 25kg/m 2 , c-section and use of assisted reproductive technologies, presence of chronic nephritis, hypothyroidism and blood pressures (BP) in the high normal range (SBP≥130 mm Hg or DBP≥ 85 mm Hg) at the first prenatal visit (before 14 weeks gestation) or before delivery were found to be independent risk factors for PPPE.…”

“…Sometimes, preeclampsia can first manifest in the postpartum period, either after a pregnancy complicated by gestational hypertension, preexisting hypertension, or more rarely after a normotensive pregnancy [4–13]. Postpartum preeclampsia (PPPE) has been most commonly defined in the literature as a systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg on at least two occasions, 4h apart and presenting more than 48h after delivery and before 6 weeks postpartum, without the need of a proteinuria [6–8, 11, 14, 15].…”

Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies

“…Some women with pregnancies complicated by GH-PE will have persistent postpartum chronic hypertension (CHTN) [8,21]. Previous studies have revealed that older age, pre-existing chronic hypertension, smoking, pre-pregnancy obesity (elevated body mass index [BMI]), and co-morbidities such as thyroid disorders are common risk factors for postpartum CHTN [22,23]. Obesity [10,12,16] and excessive weight gain [17] are risk factors for elevated BP, resulting from chronic inflammation, oxidative stress, and placental endothelial cell activation [10,12,16].…”

“…Obesity [10,12,16] and excessive weight gain [17] are risk factors for elevated BP, resulting from chronic inflammation, oxidative stress, and placental endothelial cell activation [10,12,16]. However, most of explored risk factors for CHTN are pre-pregnancy factors, based on studies with small sample sizes (< 2,000 GH-PE women) [22,23].…”