Status, outcome, and related factors of postpartum hypertension in the Shanghai community

World J Clin Cases. 2024 Jul 26;12(21):4632-4641. doi: 10.12998/wjcc.v12.i21.4632.

Abstract

Background: Postpartum hypertension poses a considerable health risk. Despite research on gestational hypertension, comprehensive studies focusing on postpartum hy-pertension in communities are limited. Understanding its prevalence and associated risk factors is crucial for effective prevention and management.

Aim: To provide insights for postpartum hypertension's prevention and management.

Methods: In total, 3297 women who gave birth between June 2021 and December 2022 in Xuhui District, Shanghai were selected. Blood pressure was measured thrice within one month post-delivery during home visits. Eighty-six women with hypertension were followed up for four months to analyze hypertension per-sistence and its related risk factors. A predictive model for persistent postpartum hypertension was established and verified using the Nomo diagram model.

Results: Hypertension prevalence 1 month post-delivery was 2.61% (86/3297). Among the 86 pregnant women, 32 (37.21 %) had persistent hypertension at four months post-delivery. Multivariate logistic regression analysis revealed that older age [odds ratio (OR) = 1.212; 95% confidence interval (CI): 1.065-1.380] and higher pre-pregnancy body mass index (BMI) (OR = 1.188; 95%CI: 1.006-1.404) were associated with hypertension (OR = 10.781; 95%CI: 1.006-1.404) during pregnancy. A 95%CI of 1.243-93.480 is a risk factor for persistent postpartum hypertension. The Nomograph model accurately predicted the risk of persistent postpartum hypertension, demonstrating high precision.

Conclusion: In Xuhui, older age, higher pre-pregnancy BMI, and gestational hypertension are risk factors for persistent postpartum hypertension. Our prediction model can identify high-risk individuals, thereby improving patient quality of life.

Keywords: High blood pressure; Hypertensive diseases during pregnancy; Nomo diagram model; Postpartum; Risk factors; Shanghai community.