Persistent hypertension at 3 months postpartum among women with hypertensive disorders of pregnancy at a tertiary hospital in Southwestern UgandaAJOG Global Reports at a Glance

Henry Mark Lugobe, MD; Musa Kayondo, PhD; Carmel M. Mceniery, PhD; Janet M. Catov, PhD; Ian B. Wilkinson, PhD; Blair J. Wylie, MD; Arthur J. Vaught, MD; Rose Muhindo, MD; Adeline A. Boatin, MD

AJOG Global Reports (Feb 2023)

Persistent hypertension at 3 months postpartum among women with hypertensive disorders of pregnancy at a tertiary hospital in Southwestern UgandaAJOG Global Reports at a Glance

Henry Mark Lugobe, MD,
Musa Kayondo, PhD,
Carmel M. Mceniery, PhD,
Janet M. Catov, PhD,
Ian B. Wilkinson, PhD,
Blair J. Wylie, MD,
Arthur J. Vaught, MD,
Rose Muhindo, MD,
Adeline A. Boatin, MD

Affiliations

Henry Mark Lugobe, MD: Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda (Drs Lugobe and Kayondo); Department of Medicine, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (Drs Lugobe, Mceniery, and Wilkinson); Corresponding author: Henry Mark Lugobe, MD.
Musa Kayondo, PhD: Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda (Drs Lugobe and Kayondo)
Carmel M. Mceniery, PhD: Department of Medicine, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (Drs Lugobe, Mceniery, and Wilkinson)
Janet M. Catov, PhD: Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA (Dr Catov)
Ian B. Wilkinson, PhD: Department of Medicine, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (Drs Lugobe, Mceniery, and Wilkinson)
Blair J. Wylie, MD: Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY (Dr Wylie)
Arthur J. Vaught, MD: Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD (Dr Vaught)
Rose Muhindo, MD: Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda (Dr Muhindo)
Adeline A. Boatin, MD: Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston MA (Dr Boatin)

Journal volume & issue: Vol. 3, no. 1
p. 100163

Abstract

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BACKGROUND: Hypertension is a key contributor to the global epidemic of cardiovascular disease and is responsible for more deaths worldwide than any other cardiovascular risk factor. Hypertensive disorders of pregnancy, of which preeclampsia and eclampsia are the most common forms, have been shown to be a female-specific risk factor for chronic hypertension. OBJECTIVE: This study aimed to determine the proportion and risk factors for persistent hypertension at 3 months after delivery among women with hypertensive disorders of pregnancy in Southwestern Uganda. STUDY DESIGN: This was a prospective cohort study of pregnant women with hypertensive disorders of pregnancy admitted for delivery at Mbarara Regional Referral Hospital in Southwestern Uganda from January 2019 to December 2019; however, women with chronic hypertension were excluded from the study. The participants were followed up for 3 months after delivery. Participants with a systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg or receiving antihypertension therapy at 3 months after delivery were considered to have persistent hypertension. Multivariable logistic regression was used to determine independent risk factors associated with persistent hypertension. RESULTS: A total of 111 participants with hypertensive disorders of pregnancy diagnosed at hospital admission were enrolled with a follow-up rate of 49% (54/111) at 3 months after delivery. Of these women, 21 of 54 (39%) had persistent hypertension 3 months after delivery. In the adjusted analyses, an elevated serum creatinine level (>106.08 µmol/L [≤1.2 mg/dL]) at admission for delivery was the only independent risk factor for persistent hypertension at 3 months after delivery (adjusted relative risk, 1.93; 95% confidence interval, 1.08–3.46; P=.03), controlling for age, gravidity, and eclampsia. CONCLUSION: Approximately 4 of 10 women presenting with hypertensive disorders of pregnancy at our institution remained hypertensive 3 months after delivery. Innovative strategies are needed to identify these women and provide long-term care to optimize blood pressure control and reduce future cardiovascular disease after hypertensive disorders of pregnancy.

Published in AJOG Global Reports

ISSN: 2666-5778 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Gynecology and obstetrics
Website: https://www.journals.elsevier.com/ajog-global-reports

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