Development and Validation of a Predictive Model for Maternal Cardiovascular Morbidity Events in Patients With Hypertensive Disorders of Pregnancy

( Anesth Analg . 2025;141(2):352-362. doi: 10.1213/ANE.0000000000007278) Approximately 2% to 8% of pregnancies are complicated by hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, preeclampsia superimposed on chronic hypertension, and eclampsia. Preeclampsia is a well-established risk factor for both short and long-term cardiovascular disease, as well as a risk factor for acute cardiovascular events at delivery and through 90 days postpartum. Though this has been established, it has not yet been established which patients are at the most risk of cardiovascular events, and implementing interventions for all patients with HDP is impractical and costly. The Obstetric Comorbidity Index (OB-CMI) was originally designed for the prediction of maternal end-organ injury or death during hospitalization for delivery, with updates targeting other forms of severe maternal morbidity; it is not, however, designed for morbidity with respect to HDP, and it was not calibrated for cardiovascular events. This study was designed to generate a novel prediction model that is specific to individuals with HDP that can predict acute cardiovascular events within delivery hospitalization and 1 year postpartum using routinely collected data.