731 Risk factors for re-admission for postpartum hypertension

Abstract

Identifying risks factors for postpartum hypertension (HTN) may lead to earlier diagnosis of the disease and improved maternal outcomes. We aimed to establish risk factors that predispose patients to readmission for postpartum HTN (regardless of their personal history of hypertension). This is a retrospective cohort study which included all deliveries at a single institution between January 1, 2012 – December 31, 2018. Case subjects included women readmitted for preeclampsia within 30 days of hospital discharge following delivery. Demographic and obstetric data were collected on all patients via data extraction and chart review. Two control groups were used for comparison: women not readmitted following delivery, and women readmitted for non-hypertensive diagnoses within 30 days of discharge following delivery. Univariable analysis were used to identify unique risk factors specific for postpartum readmission for preeclampsia. There were 46,494 women that delivered within the study window. 147 women were readmitted for postpartum HTN. 274 women were readmitted for a reason other than HTN. On univariable analysis, postpartum readmission for hypertension was significantly associated with maternal age ≥35 years (p=<0.001), black race (p=<0.001), history of gestational hypertension (p=<0.001), history of chronic hypertension (p=<0.0001), aspirin use in pregnancy (p=<0.001) and need for antihypertensive medications upon discharge (p = <0.001) compared to patients not readmitted. These same factors were also significant when the readmission for HTN group was compared to the patients admitted for another reason. Older age, black race, history of gestational hypertension and chronic hypertension, aspirin use in pregnancy, and need for antihypertensive medications upon discharge are uniquely associated with postpartum readmission for preeclampsia. Closer postpartum follow up and observation may be warranted in these patients.