Hypertensive disorders of pregnancy (HDPs) are strong risk factors for pregnancy-associated mortality due to cardiovascular disease (CVD) at delivery through one year postpartum, according to a study published online in the March issue of Paediatric and Perinatal Epidemiology.
Rachel Lee, from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues evaluated the association between HDP (chronic hypertension, gestational hypertension, preeclampsia, eclampsia, and superimposed preeclampsia) and pregnancy-associated mortality rates from all causes and CVD-related causes both at delivery and within one year following delivery. The analysis included roughly 33.4 million hospital deliveries identified from the Nationwide Readmissions Database (2010 to 2018) among females (15 to 54 years old).
The researchers found that the rate of HDP was 11.0 percent, and the pregnancy-associated mortality rate from CVD was 6.4 per 100,000 delivery hospitalizations (2,141). CVD-related pregnancy-associated mortality rates increased with HDP severity, reaching more than 58-fold higher for eclampsia patients. Risk was higher for stroke-related (1.2 to 170.9) than heart disease-related (0.99 to 39.8) mortality across all HDPs. The increased risks for CVD mortality were evident at delivery and persisted to one year postpartum for all HDPs except for gestational hypertension.
“While absolute pregnancy-associated mortality rates are low, this study supports the importance of extending postpartum care beyond the traditional 42-day postpartum visit for people whose pregnancies are complicated by hypertension,” the authors write.
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