Journal article
Antihypertensive therapy and unplanned maternal postpartum healthcare utilization in patients with mild chronic hypertension
American journal of obstetrics & gynecology MFM, v 6(12), 101525
01 Dec 2024
PMID: 39426624
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To test whether treatment of mild chronic hypertension (CHTN) in pregnancy is associated with lower rates of unplanned maternal healthcare utilization postpartum.
This was a secondary analysis of the CHTN and pregnancy study, a prospective, open-label, pragmatic, multicenter, randomized treatment trial of pregnant people with mild CHTN. All patients with a postpartum follow-up assessment were included. The primary outcome was unplanned healthcare utilization, defined as unplanned postpartum clinic visits, Emergency Department (ED) or triage visits, or unplanned hospital admissions within 6 weeks postpartum. Differences in outcomes were compared between study groups (Active Group: blood pressure goal of<140/90 mm Hg, and Control Group: blood pressure goal of <160/105 mm Hg), and factors associated with outcomes were examined using logistic regression.
A total of 2293 patients were included with 1157 (50.5%) in the active group and 1136 (49.5%) in the control group. Rates of unplanned maternal postpartum healthcare utilization did not differ between treatment and control groups, (20.2% vs 23.3%, P=.07, aOR 0.84, 95% CI 0.69–1.03). However, ED or triage/maternity evaluation unit visits were significantly lower in the Active group (10.2% vs 13.2%, P=.03, aOR 0.76, 95% 0.58–0.99). Higher BMI at enrollment and cesarean delivery were associated with higher odds of unplanned postpartum healthcare utilization.
While treatment of mild CHTN during pregnancy and postpartum was not significantly associated with overall unplanned healthcare resource utilization, it was associated with lower rates of postpartum ED and triage visits.
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Details
- Title
- Antihypertensive therapy and unplanned maternal postpartum healthcare utilization in patients with mild chronic hypertension
- Creators
- Anna Palatnik - Medical College of WisconsinJustin Leach - University of Alabama at BirminghamLorie Harper - The University of Texas at AustinBaha Sibai - University of HoustonSherri Longo - Ochsner Baptist Medical CenterLorraine Dugoff - University of PennsylvaniaKirsten Lawrence - Columbia UniversityBrenna L. Hughes - Duke UniversityJoseph Bell - St. Luke's University Health NetworkRodney K. Edwards - University of Oklahoma Health Sciences CenterKelly S. Gibson - MetroHealthCaroline Rouse - Indiana University – Purdue University IndianapolisLauren Plante - Drexel UniversityKara K. Hoppe - Meriter HospitalJanelle Foroutan - Saint Peter's University HospitalMethodius Tuuli - Brown UniversityHyagriv N. Simhan - Magee-Womens HospitalHeather Frey - Ohio State University HospitalTodd Rosen - Johnson UniversityTorri D. Metz - University of UtahSusan Baker - University of South AlabamaWendy Kinzler - New York University Langone Orthopedic HospitalEmily J. Su - University of Colorado HospitalIris Krishna - Emory UniversityMary E. Norton - San Francisco General HospitalDaniel Skupski - New York Hospital QueensYasser Y. El-Sayed - Stanford UniversityLeonardo Pereira - Oregon Health & Science UniversityEverett F. Magann - University of Arkansas for Medical SciencesMounira Habli - Cincinnati Children's Hospital Medical CenterNancy L. Geller - Office of the DirectorShauna Williams - Rutgers, The State University of New JerseyDavid S. McKenna - Wright State UniversityEugene Chang - Medical University of South CarolinaJoanne Quiñones - Lehigh Valley Hospital-PoconoJeff M. Szychowski - University of Alabama at BirminghamAlan T.N. Tita - University of Alabama at Birmingham
- Publication Details
- American journal of obstetrics & gynecology MFM, v 6(12), 101525
- Publisher
- Elsevier
- Grant note
- U01HL120338 / National Heart, Lung, and Blood Institute NCT02299414 / CHAP ClinicalTrials
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Obstetrics and Gynecology
- Web of Science ID
- WOS:001362183500001
- Scopus ID
- 2-s2.0-85208546931
- Other Identifier
- 991022202488104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology