Int J Med Sci 2020; 17(4):543-548. doi:10.7150/ijms.39432 This issue Cite

Short Research Communication

Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies

Kuo-Hu Chen1,2,✉, Li-Ru Chen3,4

1. Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan
2. School of Medicine, Tzu-Chi University, Hualien, Taiwan
3. Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei, Taiwan
4. Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu, Taiwan

Citation:
Chen KH, Chen LR. Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies. Int J Med Sci 2020; 17(4):543-548. doi:10.7150/ijms.39432. https://www.medsci.org/v17p0543.htm
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Abstract

Background: A proportion of women with pregnancies complicated by gestational hypertension/preeclampsia (GH-PE) will have persistent postpartum chronic hypertension (CHTN). Common risk factors for postpartum CHTN include older age, pre-existing CHTN, smoking, pre-pregnancy obesity (elevated BMI), and co-morbidities such as thyroid disorders. However, most of explored risk factors are pre-pregnancy factors, and were mainly based on studies with small sample size.

Methods: To investigate provoking pre-pregnancy and intra-pregnancy factors for postpartum CHTN in women with preceding GH-PE, the cohort study enrolled 22,798 index pregnancies to analyze individual characteristics, co-morbidities and postpartum outcomes after excluding women with pre-existing CHTN.

Results: Among 2,132 GH-PE pregnancies, 428 (20.1%) were complicated with postpartum CHTN. After adjustment, logistic regression analysis revealed excessive pregnant weight gain (≥10 kgw at 28 weeks' gestation) (OR: 14.50, 95% CI: 11.02-19.08) and gestational diabetes mellitus (GDM) (OR: 6.25, 95% CI: 4.98-7.85) were major risk factors for developing CHTN, other than age (OR: 1.80, 95% CI: 1.68-1.93), pre-pregnancy BMI (OR: 3.15, 95% CI: 2.75-3.60), severity of GH-PE (OR: 2.46, 95% CI: 1.97-3.07), smoking (OR: 1.79, 95% CI: 1.35-2.38), and overt DM (OR: 2.30, 95% CI: 1.73-3.06).

Conclusion: Excessive pregnant weight gain and GDM are major intra-pregnancy risk factors for postpartum CHTN in women with preceding GH-PE. Future studies should investigate interventions such as a healthy diet, appropriate physical exercise and avoidance of excessive pregnant weight gain as a means to reduce the frequency of CHTN following pregnancy.

Keywords: gestational hypertension, preeclampsia, chronic hypertension, pregnant weight gain, gestational diabetes mellitus


Citation styles

APA
Chen, K.H., Chen, L.R. (2020). Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies. International Journal of Medical Sciences, 17(4), 543-548. https://doi.org/10.7150/ijms.39432.

ACS
Chen, K.H.; Chen, L.R. Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies. Int. J. Med. Sci. 2020, 17 (4), 543-548. DOI: 10.7150/ijms.39432.

NLM
Chen KH, Chen LR. Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies. Int J Med Sci 2020; 17(4):543-548. doi:10.7150/ijms.39432. https://www.medsci.org/v17p0543.htm

CSE
Chen KH, Chen LR. 2020. Provoking factors for postpartum chronic hypertension in women with preceding gestational hypertension/preeclampsia: A longitudinal cohort study of 22,798 pregnancies. Int J Med Sci. 17(4):543-548.

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