821 Postpartum weight change and readmission for hypertension: a case-control study

Abstract

This study sought to assess whether the pattern of postpartum weight change differed between women requiring readmission for hypertension and those without hypertensive complications postpartum. This was a retrospective, case-control study of women presenting for evaluation postpartum to an obstetric triage unit between August 1, 2018 and December 31, 2019. Women readmitted for hypertensive disorders were identified as cases. Controls were identified from all others who presented to triage postpartum during the same time period. Chart review was conducted to confirm diagnosis and extract covariates. Two controls were matched with each case based on number of days between delivery and re-presentation, mode of delivery, and BMI. The primary outcome was percent weight change postpartum. Univariable statistics were used to compare additional characteristics of cases vs. controls. 91 women were identified as having been readmitted for hypertension postpartum. Women were excluded for unknown weight, multiple gestation, or preterm delivery; 69 cases were matched with 138 controls. All matched variables (re-presentation timing, mode of delivery, and BMI) were similar between the groups, as was gestational age at delivery. Age was higher among cases than controls (31.4 vs. 28.7, p = 0.0014) and cases were more likely to be multiparous (67% vs. 49%, p = 0.018). A significantly higher percentage of the cases than the controls were Black (59% vs. 32%, p = 0.001). Average percent weight loss among controls was 6.6% vs. 4.6% among cases (p = 0.0016); this amounted to an average weight loss of 0.90% per day among controls and 0.68% per day among cases, a significant difference (p = 0.028). Weight change postpartum is associated with risk of readmission for postpartum hypertension; slower weight loss postpartum may be indicative of increased risk of hypertension. Weight change is a metric that may be easily measured at home; further research is needed to determine whether monitoring of weight loss is helpful in predicting and preventing readmission for hypertension.View Large Image Figure ViewerDownload Hi-res image Download (PPT)