Predictors of persistent postpartum hypertension among women with hypertensive disorders of pregnancy: A prospective cohort study

Abstract

BackgroundPersistent postpartum hypertension in women with hypertensive disorders of pregnancy (HDP) may indicate a progression towards chronic hypertension. This study aimed to determine the prevalence and identify the predictors of persistent hypertension at six weeks after delivery among women with HDP in Vietnam. MethodsA prospective cohort study was conducted at the National Hospital of Obstetrics and Gynecology in Vietnam from March 2023 to October 2023. Our study population included women with HDP who were 18 years or above and delivered after 22 weeks of gestation. Participants were enrolled within 24 h of delivery and followed up to six weeks after delivery. Persistent hypertension was defined as a systolic blood pressure (BP) of ≥140 mm Hg or a diastolic BP of ≥90 mm Hg or receiving anti-hypertensive medications at six weeks postpartum. Bivariate and multivariable logistic regression analyses were performed to identify the predictors. ResultsOf the 343 participants initially enrolled, 293 were successfully followed up (follow-up rate 85.4 %). Among women with HDP, 10.9 % experienced persistent hypertension at six weeks after delivery. Specifically, 7.7 % of women with gestational hypertension and 11.8 % of those with preeclampsia – eclampsia remained hypertensive at this time point. Maternal age of 35 years or older, elevated serum urea level (>6.7 μmol/l), and hypertension at seven days after delivery were identified as independent predictors of persistent postpartum hypertension. ConclusionApproximately one in ten women with HDP in our study remained hypertensive at six weeks after delivery. It is crucial to implement effective strategies for identifying these women and providing timely interventions to control BP and reduce the risk of future cardiovascular complications following HDP.