(821) Risk factors associated with postpartum readmission in women with mild chronic hypertension
Friday, February 10, 2023
10:30 AM – 12:00 PM
Objective: Chronic hypertension (CHTN) is a leading cause of maternal and perinatal death and morbidities worldwide but little is known about postpartum epidemiology. We sought to identify risk factors associated with postpartum readmission (PPR) in a large diverse cohort of patients with mild CHTN.
Study Design: Planned secondary analysis of data from the CHAP trial, a large multicenter randomized trial conducted at approximately 60 perinatal US Centers, designed to evaluate the benefits and harms of pharmacologic treatment of mild CHTN in pregnancy. Subjects with a maternal death prior to the initial PP discharge, a fetal loss or delivery < 23 weeks gestation or with no information available regarding PPR were excluded.The primary outcome was readmission within 12 weeks following the initial PP discharge. Bivariate analyses described the maternal demographic and clinical characteristics of the cohort by PPR status. Variables that were significant in bivariate analysis and whose association was deemed clinically relevant were included in multivariable logistic regression analyses.
Results: Of the 2408 subjects in the CHAP trial, 2293 were eligible for inclusion and 160 of these patients (7%) were readmitted. Maternal characteristics by PPR status are shown in Table 1. Rates of private vs government assisted/Medicaid insurance (p=0.01), cesarean vs vaginal delivery (p < 0.01), and a pre-delivery composite of comorbidities differed (p=0.01) by PPR group and were independently associated with readmission in the multivariable logistic model (Table 2).
Conclusion: The findings of this study may prove to be useful in identifying patients with mild CHTN who are at risk for readmission and in developing strategies to avoid worsening outpatient morbidity and mortality as well as readmission.
Primary & Presenting Author(s)
Lorraine Dugoff, MD (she/her/hers)
University of Pennsylvania Philadelphia, Pennsylvania, United States