Persistent hypertension 3 months postpartum among women with hypertensive disorders of pregnancy in Southwestern Uganda

To determine the proportion and risk factors for persistent hypertension at 3 months postpartum among women with Hypertensive Disorders of Pregnancy (HDP) in southwestern Uganda. This was a prospective cohort study where we enrolled pregnant women admitted for delivery and diagnosed with HDP at Mbarara Regional Referral Hospital in rural southwestern Uganda from January 2019 to December 2019, excluding women with pre-existing hypertension. The participants were followed up to 3 months postpartum. Data collected included socio-demographic, obstetric, medical factors and biochemical tests. Participants with systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg or on antihypertension therapy at 3 months were considered to have persistent hypertension. We used multivariable logistic regression models to determine independent risk factors associated with persistent hypertension at 3 months postpartum. A total of 111 pregnant women with a new-onset HDP were enrolled in this study and 54 women had available information at 3 months postpartum. Most of the participants 87% (47/54) had preeclampsia with severe symptoms as shown in Table 1. Of these, 38.9% (21/54) had persistent hypertension. In adjusted analyses, serum creatinine >1.2 mg/dl at admission was the sole risk factor for persistent hypertension at 3 months postpartum (aRR 1.94, 95% CI 1.09, 3.46 p value 0.02) after controlling for age, gravidity and eclampsia as shown in Table 2. About 4 in every 10 women presenting with hypertensive disorders of pregnancy at MRRH in southwestern Uganda will remain hypertensive 3 months postpartum. Innovative postpartum and primary care strategies are needed to identify and provide long term care to this cohort of women so as to prevent chronic hypertension and future cardiovascular disease following hypertensive disorders of pregnancy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)