Factors Associated With Postpartum Readmission for Hypertension in Women With Hypertensive Disorders of Pregnancy [ID 2683562

Abstract

INTRODUCTION: Hypertensive disorders of pregnancy (HDP) are a common indication for postpartum readmissions. Our study aims to identify demographic and clinical variables associated with hypertension-related postpartum readmissions in patients with known HDP. METHODS: We conducted a retrospective cohort study at a single institution of patients who delivered between March 1, 2020, and March 31, 2022. We included patients with a HDP during their delivery admission but excluded those with chronic hypertension. Bivariate analysis was performed to identify if readmission rates were associated with maternal age, race, ethnicity, delivery route, severe disease, blood pressure before discharge, discharge timing, antihypertensive regimen inpatient and at discharge, or attendance at an outpatient blood pressure check. These variables were further stratified by race. RESULTS: Of 1,744 included patients, 68 (3.9%) were readmitted for hypertension. Odds of readmission increased if patients were greater than 35 years old (odds ratio [OR] 1.96; 95% CI, 1.13–3.41), had average blood pressure within 12 hours of discharge 140–149/90–99 (OR 1.95; 95% CI, 1.06–3.58), or if last blood pressure before discharge was 140–149/90–99 (OR 2.14; 95% CI, 1.22–3.74), and decreased if patients had severe disease (OR 0.41; 95% CI, 0.20–0.83) or received magnesium sulfate (OR 0.36; 95% CI, 0.18–0.71) during their delivery admission. Stratification by race did not elucidate any differences in risk factors. CONCLUSION: Blood pressure range in 140s/90s compared with normotension prior to discharge and advanced maternal age was associated with increased odds of postpartum readmission for hypertension. Future research and quality improvement interventions are needed regarding ideal blood pressure range prior to discharge.