OP 19 Prevalence, risk factors and associated complications of postpartum hypertension in rural Haiti

Abstract

The prevalence of hypertensive disorders during pregnancy is high in developing countries such as Haiti. While there is abundant data on antepartum hypertensive disorders, postpartum hypertension (PPHTN) has been less studied. A prospective cohort study was designed to assess prevalence, risk factors, and outcomes of PPHTN at Hospital Albert Schweitzer in rural Haiti. All consecutive pregnant women age 18 or older admitted for labor were included. Blood pressures were collected before and after delivery and medical charts were reviewed to gather pregnancy history, hospital course, diagnosis, delivery characteristics and fetal/neonatal outcomes. Differences between groups are presented based on postpartum blood pressures (BP) as mild PPHTN (systolic BP ⩾140 or diastolic BP ⩾90) and severe PPHTN (systolic BP ⩾160 or diastolic BP ⩾110). Of 175 women, the prevalence of PPHTN during the three-month study period was 57.1% (97/172) and included 56 parturients with mild and 41 with severe PPHTN. In total, 45 (26.5%) women developed de novo PPHTN (development of hypertension only after delivery) and 52 (30.6%) women had persistent PPHTN (hypertension before and after delivery). Severe PPHTN was associated with a higher proportion of complications including abruption (14.6%), fetal (14.6%) and neonatal death (7.3%). Forty-four (78.6%) patients with mild PPHTN and 18 (43.9%) patients with severe PPHTN did not receive any antihypertensive medications postpartum. Patients with severe PPHTN had prolonged hospitalization compared to the normal group (3.5 vs. 2.0 days, p = 0.0003). There was a strong correlation between antepartum and postpartum systolic and diastolic BP’s (r = 0.62 and 0.54, p < 0.0001, respectively). In this study, we identified a high prevalence of PPHTN in rural Haiti. Severe PPHTN was associated with adverse outcomes and treatment is not universal. This data is a starting point to develop region-specific protocols to treat and control PPHTN.Download : Download high-res image (138KB)Download : Download full-size imageDownload : Download high-res image (91KB)Download : Download full-size image