Are Longer Periods of Latency After the Diagnosis of Preeclampsia Associated With Readmission? [31G

Abstract

INTRODUCTION: To determine if longer periods of latency after the diagnosis of preeclampsia with severe features is associated with postpartum readmission or complications. METHODS: This was a nested case control study of all patients with severe preeclampsia at an academic medical center from 2014 until 2017. The primary outcome was readmission within six weeks of discharge. The primary exposure was pregnancy latency after the diagnosis of preeclampsia with severe features until delivery. Secondary exposures were the differing severe features or complications of preeclampsia which the patients were diagnosed with during their antepartum admission. Controls were randomly selected from the patients who had been diagnosed with preeclampsia with severe features in a 2:1 ratio. Median latency, baseline characteristics, severe features, and complications of preeclampsia were compared between patients who were readmitted and those who were not. RESULTS: Of the 18,645 deliveries over this time period, 950 were complicated by preeclampsia with severe features. Of these deliveries, 39 were readmitted. The median gestational age on admission was 37 weeks and one day. Contrary to our hypothesis, readmission was more likely with shorter latencies (mean rank 65 vs 45, p<0.01). Pregestational diabetes was a risk factor for readmission (OR 3.2, p=0.04); Antepartum headache (OR 0.36, p=0.02), parenteral antihypertensives (OR .30, p<0.01), oral antihypertensives (OR 0.25, p<0.01), antepartum magnesium sulfate (OR 0.07, p<0.01) during the initial admission were protective. CONCLUSION: Analyzing the factors that contribute to readmission in preeclamptic patients allow us to be cognizant of factors that may lead to increased maternal morbidity and mortality.