Postpartum Hypertension Risk is 6-fold Higher in Women Who Experience Pre-Eclampsia

Takeaway

• The risk of developing hypertension within 2 years was 6-fold higher in women with a history of hypertensive disorders of pregnancy (HDP) than in women after normotensive pregnancy.
• The risk of postpartum hypertension was more than 10-fold in the first 6 months, 4-fold at 6-12 months, and 8-fold at 1-2 years.

Why this matters

• Findings highlight the importance of early diagnosis and intervention for hypertension to improve maternal cardiovascular health in the immediate postpartum period after a pregnancy complicated by HDP.

Study design

• Meta-analysis of 15 studies that compared hypertension rate in the first 2 years in women with a history of HDP (n=1646) and in those with a previous uneventful pregnancy (n=6395).
• Funding: iPLACENTA project.

Key results

• The percentage of women who developed hypertension in the first 2 years following pregnancy was 28.4% and 9.1% in the HDP and control groups, respectively (OR, 6.28; 95% CI, 4.18-9.43; I², 56%).
• The OR (95% CI) of postpartum hypertension in HDP group was:
  • 18.33 (1.35-249.48) in the period up to 6 months (I²=84%);
  • 4.36 (2.81-6.76) in the period from 6-12 months (I²=56%); and
  • 7.24 (4.44-11.80) between 1 and 2 years.
• In subgroup analysis, a similar increase in the risk of developing postpartum hypertension was observed after HDP (OR, 5.75; 95% CI, 3.92-8.44) and pre-eclampsia (OR, 6.83; 95% CI, 4.25-10.96; I²=53%).

Limitations

• Heterogeneity among included studies.
• Selection bias.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.