Category: Hypertension
Poster Session III
We performed a retrospective cohort study in patients with a singleton gestation and a diagnosis of a hypertensive disorder of pregnancy at their delivery admission or at any point during their pregnancy who delivered 1 year prior and 1 year after the implementation of a policy of extended monitoring of postpartum hypertension (EM). The primary outcome was readmission for PreE with SF within 6 weeks of delivery. Secondary outcomes were length of stay during first admission, number of readmissions and intensive care admission. Univariable analyses were performed for the association between baseline maternal characteristics and the primary outcome. Multivariable analysis was performed for the primary outcome to adjust for baseline differences in maternal characteristics between exposure groups.
Results:
567 patients met inclusion criteria of which 248 patients delivered prior and 319 delivered after the implementation of EM. For baseline characteristics, compared to the pre-intervention group, the EM group had a significantly higher proportion of patients who were non-Hispanic Black and Hispanic, fewer antepartum diagnoses of hypertensive disorders and/or diabetes (pre-existing or gestational), had a higher BMI, and fewer were discharged on labetalol (Table 1). In univariable analysis, EM was not associated with a decreased rate of readmission (6.5% vs. 7.8%, p=0.528) nor in the multivariable analysis (aOR 1.36, 95% CI 0.60-2.06, p-value 0.459). Secondary outcomes were not significant (Table 2).
Conclusion: EM with strict postpartum blood pressure guidelines does not lead to fewer readmissions for PreE with SF in the postpartum period.
Baillie Bronner, MD (she/her/hers)
Rush University Medical Center
Chicago, Illinois, United States
Patrice Trowbridge, BS
Rush University Medical Center
Chicago, Illinois, United States
Anna Perry, BS
Rush University Medical Center
Chicago, Illinois, United States
Thaddeus Waters, MD
Loyola University Medical Center
Maywood, Illinois, United States
Anna McCormick, DO
Rush University Medical Center
Chicago, Illinois, United States
Samantha de los Reyes, MD
Fellow
University of Chicago and NorthShore University Health System
Evanston, Illinois, United States