Severe Range Blood Pressures and the Association With Hypertension Up to 2 Years Post-Delivery [31P

Abstract

INTRODUCTION: While hypertension can normalize soon after delivery, some women experience prolonged periods of hypertension. We sought to determine whether severe range blood pressures on labor and delivery are associated with having hypertension 12 weeks to 2 years after delivery. METHODS: Retrospective cohort study of pregnancies with a delivery from 7/2009-7/2016. Inclusion criteria were delivery at our tertiary hospital, presence of hypertensive disorder, and a documented blood pressure 12 weeks-2 years postpartum. Blood pressures were documented for every visit between 12 weeks and 2 years postpartum. A logistic regression model was used to determine the odds of hypertension in the 2 years following delivery. Multivariable logistic regression analysis was used to adjust for confounding factors. RESULTS: 524 women met inclusion and exclusion criteria. Of these, 127 (24%) women had at least one severe range blood pressure during their hospitalization for delivery. Women with severe blood pressures were more likely to have a history of or current gestational hypertension, but less likely to have IUGR (p<0.05). Other variables were similar. However, women with severe range blood pressures during delivery hospitalization did not show a greater rate of hypertension from 12 weeks - 2 years in either unadjusted (OR 1.24 [0.83-1.85], p=0.30) or adjusted analysis (OR 1.24 [0.80-1.9], p=0.34). CONCLUSION: While 24% of women in our cohort had severe range hypertension, this was not associated with hypertension up to 2 years post-delivery. It is important to encourage all women with hypertensive disorders to follow up closely, as this alone does not seem to identify those at highest risk.