More Than 12 Percent Develop De Novo Postpartum Hypertension

Risk for developing de novo postpartum hypertension was increased for those aged 35 years or older, with caesarean delivery, for current or former smokers.

HealthDay News — In the year after delivery, more than 12 percent of patients with normotensive pregnancies experience de novo postpartum hypertension (dn-PPHTN), according to a study published online Nov. 15 in Hypertension.

Samantha E. Parker, Ph.D., from the Boston University School of Public Health, and colleagues conducted a retrospective cohort study involving 3,925 deliveries from 2016 to 2018. Blood pressure (BP) measures were extracted from medical records during pregnancy and through 12 months postpartum. Having two separate BP readings with systolic BP ≥140 mm Hg and diastolic BP ≥90 mm Hg at least 48 hours after delivery was used to define dn-PPHTN; severe dn-PPHTN was defined as systolic and diastolic BP ≥160 and ≥110 mm Hg, respectively.

The researchers found that 12.1 percent of the 2,465 patients without a history of hypertension developed dn-PPHTN, 17.1 percent of whom had severe dn-PPHTN. Cases were more likely to be aged 35 years or older, delivered via cesarean, or current or former smokers compared with those without dn-PPHTN. The risk for developing dn-PPHTN was 29 percent for patients with all of these characteristics and was elevated among non-Hispanic Black patients (36 percent). Of the cases, about 22 percent were diagnosed after six weeks postpartum.

“Selected patient characteristics known before hospital discharge may identify those at significantly higher risk,” the authors write. “Strategies to manage women with dn-PPHTN may serve as an opportunity to reduce postpartum hospital readmission and cardiovascular-related maternal morbidity.”

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