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Hypertensive Disorders at Delivery and Postpartum Cardiovascular Morbidity: A Retrospective Cohort Study
Mariam Ayyash1, Timothy Wen2,3, Stephanie Purisch1
1Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York City, New York, USA.
BJOG : an International Journal of Obstetrics and Gynaecology
|October 22, 2025
Summary
Hypertensive disorders during delivery significantly increase the risk of postpartum cardiovascular severe maternal morbidity (SMM) readmission. Specific diagnoses like superimposed preeclampsia pose the highest risk, highlighting the need for targeted postpartum care.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Health
- Public Health
Background:
- Hypertensive disorders are common during pregnancy and delivery.
- Postpartum readmission for severe maternal morbidity (SMM) is a significant concern.
- The association between delivery hypertensive diagnoses and cardiovascular SMM readmission requires further investigation.
Purpose of the Study:
- To analyze the association between hypertensive diagnoses at delivery and subsequent postpartum readmission for cardiovascular SMM.
- To evaluate the impact of specific hypertensive diagnoses on postpartum cardiovascular SMM readmission risk.
Main Methods:
- Retrospective cohort study using the 2016-2022 Nationwide Readmissions Database.
- Analysis of delivery hospitalizations with subsequent 6-month postpartum readmissions for cardiovascular SMM.
- Multivariable logistic regression models were used to estimate adjusted odds ratios (aORs).
Main Results:
- 15.4% of 12.0 million delivery hospitalizations had a hypertensive diagnosis.
- Hypertensive diagnoses at delivery were associated with increased odds of 6-month postpartum cardiovascular SMM readmission (aOR 2.8).
- Individual diagnoses like superimposed preeclampsia (aOR 4.3) and chronic hypertension (aOR 3.2) showed significant associations.
Conclusions:
- Hypertensive disorders at delivery are significant risk factors for postpartum cardiovascular SMM readmission.
- Specific hypertensive diagnoses confer distinct levels of risk for adverse cardio-obstetric outcomes.
- Identifying patients with hypertensive disorders is crucial for improving postpartum care quality and patient risk stratification.
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