Almost one-quarter of women in a retrospective study developed de novo postpartum hypertension after 6 weeks and within a year of childbirth in a new research published in the journal Hypertension.¹

In this single-center study, researchers analysed medical records of 2465 women with a pregnancy length of at least 20 weeks who had delivered at the Boston Medical Center from 2016-2018. These women were not hypertensive and also did not have gestational hypertension. 54% were non-Hispanic Black, while 18% were Hispanic or Latino. They aimed to determine the risk of new-onset postpartum hypertension in this study group defined as BP ≥140/90 mm Hg on two separate readings. A BP reading of ≥160/110 mm Hg was considered as severe high BP. BP readings in the first year after delivery were noted from the medical records

Twelve percent of women (n=298) without hypertension were found to have developed de novo postpartum hypertension within one year of childbirth; of these 17% (n=51) had severe hypertension. Although the majority could be diagnosed soon after childbirth, 22% women were diagnosed as hypertensive ≥6 weeks after delivery. Age ≥35 years, cesarean births or cigarette smoking (current or former) were identified as the risk factors for hypertension. The risk of new-onset postpartum high BP was 29% higher among women who had all these three risk factors. The risk increased to 36% if the women were also non-Hispanic Black.

Since 22% cases were diagnosed after 6 weeks of delivery, this study draws attention to the need to monitor women even beyond the required routine postpartum follow-up. Not doing so could miss many cases of new-onset hypertension, which may remain undiagnosed and cause significant maternal morbidity and mortality.

Reference

1. Parker SE, et al. De novo postpartum hypertension: incidence and risk factors at a safety-net hospital. Hypertension. 2022 Nov 15;101161HYPERTENSIONAHA12219275. doi: 10.1161/HYPERTENSIONAHA.122.19275.