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Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia
Author(s) -
Keepanasseril Anish,
Thilaganathan Baskaran,
Velmurugan Bharathi,
Kar Sitanshu S.,
Maurya Dilip K.,
Pillai Ajith A.
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13281
Subject(s) - medicine , eclampsia , odds ratio , obstetrics , chronic hypertension , confidence interval , cohort , pregnancy , cohort study , preeclampsia , genetics , biology
Abstract Objective To assess the prevalence of new‐onset postpartum chronic hypertension (PPCH) after pre‐eclampsia and to determine the factors are associated with it. Methods This study was conducted in a tertiary center in south India, between June 2018 and February 2019, consisting of pre‐eclamptic women who were recruited as part of an ongoing cohort and had completed at least 3 months of postpartum follow‐up. Demographic, medical, and laboratory details were collected. Primary outcome was a diagnosis of new‐onset PPCH at 3 months. Results PPCH at 3 months was noted in 32 (18.1%) women. During postnatal follow‐up, 2 (1.1%) women experienced hemiplegia from stroke and 19 (10.7%) had elevated serum creatinine levels (>1.1 mg/dL). On multivariate analysis, advancing maternal age (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.01–1.21), multiparity (aOR 2.79, 95% CI 1.07–7.24), and eclampsia (aOR 3.07, 95% CI 1.03–9.13) increased the risk of PPCH at 3 months postpartum. Conclusion One in five women present with a diagnosis of new‐onset PPCH within 3 months postpartum in a cohort of predominantly preterm and/or severe pre‐eclampsia. A significant but weak association of PPCH with peripartum clinical characteristics was noted. The role of biochemical, hemodynamic, and echocardiographic biomarkers should be evaluated for prediction of PPCH after pre‐eclampsia in future studies.