(989) Postpartum furosemide and rates of readmission in women with hypertensive disorders of pregnancy

Hypertensive disorders of pregnancy (HDP) remain a primary driver of maternal postpartum readmission and a cause of maternal mortality; however, the optimal pharmacological approach to management of postpartum hypertension has not been established. 

The objective of this study was to evaluate readmission rates due to hypertension complications between women with HDP who received postpartum furosemide versus those who did not.

Study Design:

This was a retrospective cohort study of women admitted with hypertensive disorders of pregnancy who delivered between Jan. 1st, 2016 - Dec. 31st, 2021 at any gestational age. All subjects who were admitted to the resident-teaching service with ICD10 codes related to HDP were included in the study. The primary exposure was postpartum furosemide administration during their delivery hospitalization. The primary outcome was readmission rate due to hypertension complications. Bivariate analyses of baseline characteristics were conducted and logistic regression modeling was used to adjust for gestational age.


Results:

Of the 3,687 subjects identified meeting all inclusion criteria, 2,705 (73.4%) did not receive postpartum furosemide and 982 (26.6%) did. Baseline maternal demographics differed by age, race, parity, BMI, gestational age, mode of delivery, frequency of multiple gestations, and distribution of specific hypertensive diagnoses. Our primary outcome, readmission related to hypertension, occurred in 69 (2.5%) subjects who did not receive furosemide and 15 (1.5%) subjects who did (Table 1, p=0.07). When adjusting for confounders, this difference was not statistically significant (OR 0.84, p=0.61) (Table 2). A subgroup analysis including only women with severe preeclampsia (n=1,180) showed no significant difference in readmission rate for hypertension complications between women who received postpartum furosemide (0.9%) versus those who did not (1.3%) (p=0.54).

 


Conclusion:

For women with hypertensive disorders of pregnancy, postpartum receipt of furosemide does not appear to modify the risk of postpartum readmission.