Key result
Elevated admission creatinine linked to ~93% higher risk of persistent postpartum hypertension.
Why the study?
Hypertensive disorders of pregnancy are a female-specific risk factor for chronic hypertension, but the proportion and risk factors for persistent hypertension postpartum in Southwestern Uganda were unknown.
Does elevated serum creatinine at admission predict persistent hypertension 3 months postpartum in women with hypertensive disorders of pregnancy?
Cohort (n=111)
No
Does elevated serum creatinine at admission predict persistent hypertension 3 months postpartum in women with hypertensive disorders of pregnancy?
Relative Risk: 1.93 (95% CI 1.08–3.46)
Absolute Event Rate: 63.6% vs 32.6%
p-value: p=0.03
An elevated serum creatinine level at admission in women with pregnancy-induced hypertension is a strong independent predictor of persistent hypertension at 3 months postpartum.
May support targeted postpartum monitoring for women with elevated creatinine; extends prior cohorts but remains hypothesis-generating pending validation.
Hypertension is a key contributor to the global epidemic of cardiovascular disease and is responsible for more deaths worldwide than any other cardiovascular risk factor. Hypertensive disorders of pregnancy, of which preeclampsia and eclampsia are the most common forms, have been shown to be a female-specific risk factor for chronic hypertension. This study aimed to determine the proportion and risk factors for persistent hypertension at 3 months after delivery among women with hypertensive disorders of pregnancy in Southwestern Uganda. This was a prospective cohort study of pregnant women with hypertensive disorders of pregnancy admitted for delivery at Mbarara Regional Referral Hospital in Southwestern Uganda from January 2019 to December 2019; however, women with chronic hypertension were excluded from the study. The participants were followed up for 3 months after delivery. Participants with a systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg or receiving antihypertension therapy at 3 months after delivery were considered to have persistent hypertension. Multivariable logistic regression was used to determine independent risk factors associated with persistent hypertension. A total of 111 participants with hypertensive disorders of pregnancy diagnosed at hospital admission were enrolled with a follow-up rate of 49% (54/111) at 3 months after delivery. Of these women, 21 of 54 (39%) had persistent hypertension 3 months after delivery. In the adjusted analyses, an elevated serum creatinine level (>106.08 µmol/L [≤1.2 mg/dL]) at admission for delivery was the only independent risk factor for persistent hypertension at 3 months after delivery (adjusted relative risk, 1.93; 95% confidence interval, 1.08–3.46; P=.03), controlling for age, gravidity, and eclampsia. Approximately 4 of 10 women presenting with hypertensive disorders of pregnancy at our institution remained hypertensive 3 months after delivery. Innovative strategies are needed to identify these women and provide long-term care to optimize blood pressure control and reduce future cardiovascular disease after hypertensive disorders of pregnancy.
No takes yet. Share an insight, caveat, or question.
Lugobe et al. (2023) conducted a cohort in Hypertensive disorders of pregnancy (n=111). Elevated serum creatinine level (>106.08 µmol/L) vs. Normal serum creatinine level (≤106.08 µmol/L) was evaluated on Persistent hypertension at 3 months after delivery (adjusted RR 1.93, 95% CI 1.08-3.46, p=0.03). Elevated serum creatinine (>106.08 µmol/L) at admission was independently associated with an increased risk of persistent hypertension 3 months postpartum in women with hypertensive disorders of pregnancy (RR 1.93, 95% CI 1.08-3.46, P=0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: