Can Normotensive Pregnancies Lead to Hypertension?

TOPLINE:
Nearly 18% of previously normotensive pregnancies develop hypertension by 6 months postpartum. Non-Hispanic Black patients and those with body mass index (BMI) ≥ 30 are at a higher risk.
METHODOLOGY:
Researchers conducted a retrospective cohort study using an internal obstetric database covering deliveries between 2013 and 2022 with Institutional Review Board’s approval (Yale HIC #1605017853).
A total of 7730 patients without chronic hypertension, hypertensive disorders of pregnancy (HDP), or elevated blood pressure (BP) at < 6 weeks postpartum were included.
BP measurements from fertilization to 6 months postpartum were obtained from electronic medical records to categorize hypertensive status.
Patients with fewer than two BP measurements from the first prenatal visit to < 20 weeks of gestation, or with chronic hypertension or HDP (as defined by the International Classification of Diseases – 10th revision code) during pregnancy, were excluded.
TAKEAWAY:
According to the authors, nearly 18% of patients in a previously normotensive cohort developed BP abnormalities by 6 months postpartum.
The authors stated that 8.2% of the study population progressed to stage I or II hypertension, which would not be included in current strategies for targeted postpartum BP monitoring.
Patients with a BMI ≥ 30 at the end of pregnancy were more likely to develop stage I or II hypertension in the late postpartum period (adjusted odds ratio [aOR], 1.81; 95% CI, 1.52-2.15).
Non-Hispanic Black patients had higher odds of developing de novo hypertension in the late postpartum period than non-Hispanic White patients (aOR, 1.42; 95% CI, 1.11-1.82).
IN PRACTICE:
“By 6 months postpartum, nearly one fifth of this large, previously normotensive cohort had developed BP abnormalities as per American College of Cardiology-American Heart Association criteria. These findings underscore the importance of optimizing the transition from obstetrics to primary care in the postpartum period,” wrote the authors of the study.
SOURCE:
The study was led by Colleen Sinnott, MD, at Yale School of Medicine in New Haven, Connecticut. It was published online in Obstetrics & Gynecology.
LIMITATIONS:
The study was limited by the exclusion of patients with insufficient BP data for the late postpartum period, which may affect the generalizability of the findings. Additionally, the retrospective design may have introduced biases related to data collection and patient selection.
DISCLOSURES:
No potential conflicts of interest were reported by the authors. Additional disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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