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Chronic Hypertension and the Risk of Readmission for Postpartum Cardiovascular Complications

Emily B Rosenfeld1, Justin S Brandt, Jessica C Fields

  • 1Division of Maternal-Fetal Medicine and the Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, the Cardiovascular Institute of New Jersey, and the Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, and the Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey; the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, NYU Langone Health, New York, New York; and the Clinical Epidemiology Division, Faculty of Medicine at Solna, Karolinska Institutet, Stockholm, Sweden.

Obstetrics and Gynecology
|November 2, 2023
PubMed

Insights

Chronic hypertension during pregnancy significantly increases the risk of cardiovascular disease (CVD) complications within a year after delivery. This highlights the need for postpartum monitoring to manage blood pressure and prevent heart disease and stroke.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Public Health

Background:

  • Preeclampsia is a known risk factor for long-term cardiovascular disease (CVD).
  • The impact of chronic hypertension without preeclampsia on immediate postpartum CVD risk is not well understood.

Purpose of the Study:

  • To assess the risk of readmission for CVD complications within one year postpartum among individuals with chronic hypertension.
  • To investigate the association between chronic hypertension during pregnancy and postpartum CVD events.

Main Methods:

  • Retrospective cohort study using the Nationwide Readmission Database (2010-2018).
  • Included singleton births, identified chronic hypertension and CVD readmissions using ICD codes.
  • Excluded preeclampsia, eclampsia, multiple births, and pre-existing CVD.

Main Results:

  • 2.0% of deliveries involved individuals with chronic hypertension.
  • Chronic hypertension was associated with a significantly higher rate of CVD readmission (645 vs. 136 per 100,000 deliveries).
  • The elevated CVD risk persisted up to one year postpartum.

Conclusions:

  • Chronic hypertension in pregnancy elevates CVD risk in the early postpartum period.
  • Close postpartum monitoring and timely interventions are crucial for managing blood pressure and preventing CVD complications.
Abstract

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