Pregnancy hypertension · 2026
Postpartum readmission for hypertension: Impact of blood pressure stage at initial discharge.
СтатьяНазвание и аннотация: Перевод в очереди
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Pressman Katherine, Cain Mary Ashley, Crousillat Daniela, Tsalatsanis Athanasios, Louis Judette
Аннотация
OBJECTIVE: We sought to evaluate blood pressure (BP) thresholds associated with postpartum readmission for hypertension (HTN).
STUDY DESIGN: Retrospective cohort study.
MAIN OUTCOME MEASURES: Demographics and comorbidities, including hypertensive disorders, were identified by ICD-10 codes. Readmissions for indications other than hypertension were excluded. Average BP over the 24 h prior to initial discharge was classified as normal (systolic < 130 mmHg, diastolic < 80 mmHg), stage 1 hypertension (systolic 130-139, diastolic 80-89), and stage 2 hypertension (systolic ≥ 140, diastolic ≥ 90). Association with readmission was determined, and rates of individual and composite severe maternal morbidity.
RESULTS: During the study period, there were 29,195 deliveries, 557 (1.9%) readmissions, 283 for hypertension (0.96% of all deliveries, 51% of all readmissions). Readmitted patients were more likely to have chronic hypertension, diabetes, substance use, mental health disorders, advanced maternal age, and cesarean delivery. There was no difference in rate of prescription for antihypertensives at the time of initial discharge. After controlling for confounding variables (controlling for race, hypertensive disorder at time of delivery, diabetes, body mass index, age, mode of delivery, substance use, gestational age at delivery, and diagnosis of mental health disorder), patients with stage 1 (aOR 3.03 [95% confidence interval (CI) 2.15-4.27]) or stage 2 (aOR 3.58 [95% CI 2.29-5.59]) HTN prior to initial discharge were associated with readmission.
CONCLUSION: When compared to normotensive patients within the 24 h prior to initial discharge, patients with stage 1 or stage 2 hypertension were three times as likely to be readmitted for postpartum hypertension.
STUDY DESIGN: Retrospective cohort study.
MAIN OUTCOME MEASURES: Demographics and comorbidities, including hypertensive disorders, were identified by ICD-10 codes. Readmissions for indications other than hypertension were excluded. Average BP over the 24 h prior to initial discharge was classified as normal (systolic < 130 mmHg, diastolic < 80 mmHg), stage 1 hypertension (systolic 130-139, diastolic 80-89), and stage 2 hypertension (systolic ≥ 140, diastolic ≥ 90). Association with readmission was determined, and rates of individual and composite severe maternal morbidity.
RESULTS: During the study period, there were 29,195 deliveries, 557 (1.9%) readmissions, 283 for hypertension (0.96% of all deliveries, 51% of all readmissions). Readmitted patients were more likely to have chronic hypertension, diabetes, substance use, mental health disorders, advanced maternal age, and cesarean delivery. There was no difference in rate of prescription for antihypertensives at the time of initial discharge. After controlling for confounding variables (controlling for race, hypertensive disorder at time of delivery, diabetes, body mass index, age, mode of delivery, substance use, gestational age at delivery, and diagnosis of mental health disorder), patients with stage 1 (aOR 3.03 [95% confidence interval (CI) 2.15-4.27]) or stage 2 (aOR 3.58 [95% CI 2.29-5.59]) HTN prior to initial discharge were associated with readmission.
CONCLUSION: When compared to normotensive patients within the 24 h prior to initial discharge, patients with stage 1 or stage 2 hypertension were three times as likely to be readmitted for postpartum hypertension.