Abstract
INTRODUCTION: Based on the Hypertension in Pregnancy Task Force guidelines, we examined if NSAID administration adversely affects blood pressures in the immediate postpartum (PP) period in women with HDP (hypertensive disorders of pregnancy). METHODS: This cross sectional study examined patients with HDP who delivered at our institution from April 2012 to April 2015. Mean systolic (SBP) and diastolic (DBP) blood pressures over the first 24 hours were compared by NSAID exposure using Student's t-test or Chi-square test of proportions. Multivariable linear regression was used to adjust for confounding. Exploratory repeated measures analyses were performed. RESULTS: 130 subjects with HDP were identified; 103 (79%) were exposed to NSAIDs. Mean SBP in NSAID exposed and unexposed was 132.5 ± 10.7 vs 140.9 ± 10.4 mmHg, respectively (p < 0.01). Mean DBP in NSAID exposed and unexposed was 79.0 0 ± 7.1 and 84.8 ± 8.4 mmHg, respectively (p = 0.01). In multivariable modeling, only magnesium exposure and earlier gestational age remained significantly associated with higher SBP. Of 46 women with severe preeclampsia, 26 (43.5%) were exposed to NSAIDs. Mean SBP in NSAID exposed and unexposed was 137.7 ± 13.0 and 143.7 ± 9.9 mmHg (p=0.09). Repeated measures analysis of blood pressures showed similar results. CONCLUSION: Administration of NSAIDs did not appear to be associated with higher mean SBP or DBP immediately PP. NSAID exposure was associated with significantly lower SBP and DBP. This suggests NSAIDs may not adversely affect BP immediately PP, but a randomized controlled trial is needed to provide higher level evidence.
Published Version
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