Factors associated with postpartum follow-up and persistent hypertension among women with severe preeclampsia

Abstract

Objective:To determine factors associated with lower 6-week postpartum follow-up rates and persistent hypertension among women with preeclampsia with severe features (PEC-S).Study Design:Planned secondary analysis of a retrospective cohort study of women with PEC-S. Outcomes were (1) attendance at the 6-week postpartum visit and (2) persistent hypertension.Results:One hundred ninety-three women were in the final cohort. The 6-week follow-up rate was 52.3%. Factors associated with lower follow-up were African-American race (OR 0.37 (0.18-0.77)) and <5 prenatal visits (OR 0.44 (0.20-0.97)). Women with diabetes and women with a cesarean had higher follow-up (OR 4.00 (1.09-14.66) and 2.61 (1.40-4.88), respectively). Among those with 6-week follow-up, 21% had persistent hypertension. Obese women, women diagnosed with PEC-S by severe range blood pressure (BP) and women discharged home on BP medication were more likely to have persistent hypertension (OR 3.50 7 (1.06-11.58), 3.58 (1.11-11.54) and 3.04 (1.12-8.23), respectively).Conclusion:We identified a subgroup of women at higher risk for poor postpartum follow-up and those at risk for persistent hypertension.