Factors associated with attendance at the postpartum blood pressure visit in pregnancies complicated by hypertension

• Published in: Pregnancy hypertension 2020-10, Vol.22, p.216-219
• Main Authors: Romagano, Matthew P., Williams, Shauna F., Apuzzio, Joseph J., Sachdev, Devika, Flint, Matthew, Gittens-Williams, Lisa
• Format: Article
• Language: English
• Subjects: Hypertension in pregnancy; Maternal morbidity; Maternal mortality; Postpartum care; Postpartum visit; Preeclampsia
• ISSN: 2210-7789; 2210-7797
• DOI: 10.1016/j.preghy.2020.10.003

•Hypertension is a leading cause of maternal and perinatal morbidity and mortality.•Postpartum follow-up is notoriously poor, especially in minority populations.•Rates of adherence to a postpartum 1-week blood pressure visit are unknown.•Hypertensive women with preeclampsia or a cesarean are more likely to return.•Black/non-Hispanic women are much less likely to return for this visit. Women with hypertensive disorders of pregnancy should have a blood pressure evaluation no later than 7–10 days after delivery. The objective of this study was to identify the factors associated with patient attendance at the postpartum blood pressure follow-up visit. This was a retrospective cohort study of postpartum women who had a hypertensive disorder of pregnancy. Postpartum follow-up rates were recorded, and characteristics of women who attended a postpartum visit for blood pressure evaluation were compared to women who did not return for the visit. Multiple logistic regression was performed. Characteristics of women who returned for a blood pressure visit. There were 378 women who met inclusion criteria; 193(51.1%) attended the blood pressure visit. Women who returned were older and more likely to have preeclampsia, severe features, magnesium sulfate use, or severe hypertension during hospitalization. They were less likely to have gestational hypertension. Adjusted analysis demonstrated that black/non-Hispanic women (OR 0.53, 95% CI 0.34–0.83), the presence of any preeclampsia diagnosis (OR 2.19, 95% CI 1.03–4.81), and whether the woman underwent a cesarean delivery (OR 3.06, 95% CI 1.85–5.14) remained significant factors in predicting adherence. Women who returned for a blood pressure visit were more likely to have had significant hypertensive disease or a cesarean delivery. Non-Hispanic black women had the lowest rate of follow-up. Given black women have the highest rates of maternal morbidity and mortality nationwide, effective interventions to increase follow-up for them are needed.