Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia

Objective To assess the prevalence of new‐onset postpartum chronic hypertension (PPCH) after pre‐eclampsia and to determine the factors are associated with it. Methods This study was conducted in a tertiary center in south India, between June 2018 and February 2019, consisting of pre‐eclamptic women who were recruited as part of an ongoing cohort and had completed at least 3 months of postpartum follow‐up. Demographic, medical, and laboratory details were collected. Primary outcome was a diagnosis of new‐onset PPCH at 3 months. Results PPCH at 3 months was noted in 32 (18.1%) women. During postnatal follow‐up, 2 (1.1%) women experienced hemiplegia from stroke and 19 (10.7%) had elevated serum creatinine levels (>1.1 mg/dL). On multivariate analysis, advancing maternal age (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.01–1.21), multiparity (aOR 2.79, 95% CI 1.07–7.24), and eclampsia (aOR 3.07, 95% CI 1.03–9.13) increased the risk of PPCH at 3 months postpartum. Conclusion One in five women present with a diagnosis of new‐onset PPCH within 3 months postpartum in a cohort of predominantly preterm and/or severe pre‐eclampsia. A significant but weak association of PPCH with peripartum clinical characteristics was noted. The role of biochemical, hemodynamic, and echocardiographic biomarkers should be evaluated for prediction of PPCH after pre‐eclampsia in future studies. Biochemical, hemodynamic, or echocardiographic biomarkers should be evaluated, as a weak association with peripartum chacracteristics on postpartum chronic hypertension in pre‐eclamptic women is only noted.