Characteristics of Patients Who Attend the 7- to 10-Day Postpartum Visit for Blood Pressure Evaluation

Abstract

Objective This study aimed to assess maternal characteristics that predict attendance of postpartum blood pressure evaluation in patients with hypertensive disorders of pregnancy (HDP).

Study Design A retrospective case–control study of patients with HDP delivering at a single academic institution (2014–2018). Diagnosis of HDP included gestational hypertension, chronic hypertension, preeclampsia, and superimposed preeclampsia. Univariable and multivariable analyses were used to determine maternal characteristics independently associated with attendance of the 7- to 10-day postpartum blood pressure evaluation.

Results Of the 1,041 patients included in the analysis, 603 (57.9%) attended the 7- to 10-day postpartum blood pressure check. Maternal sociodemographic, clinical, and obstetric factors differed significantly between patients who attended the postpartum blood pressure visit and those who did not. In univariable analyses, nulliparity, non-Hispanic black race and ethnicity, public insurance, HDP with severe features, cesarean birth, gestational age at delivery, receipt of magnesium, mild-range blood pressures on day of discharge, and initiation of antihypertensive medication were associated with attendance of the 7- to 10-day postpartum visit. In multivariable analysis, factors significantly associated with higher odds of attending the blood pressure visit were nulliparity (adjusted odds ratio [aOR]: 1.58; 95% confidence interval: [CI]: 1.14–2.17), severe HDP (aOR: 1.94, 95% CI: 1.44–2.61), and cesarean birth (aOR: 1.92, 95% CI: 1.43–2.59). In contrast, factors associated with lower odds of attendance were non-Hispanic black race and ethnicity compared with non-Hispanic white (aOR: 0.68, 95% CI: 0.47–0.97), and public insurance (aOR: 0.65, 95% CI: 0.45–0.93) compared with private insurance.

Conclusion Clinical factors such as nulliparity, severe HDP, and cesarean birth were associated with higher rates of postpartum blood pressure evaluation attendance, whereas sociodemographic factors such as maternal non-Hispanic black race and ethnicity and public insurance were associated with lower odds of postpartum blood pressure check attendance.

Key Points

• A total of 57.9% of patients with HDP attended in person postpartum blood pressure check.

• Nulliparity, severe features of HDP, and cesarean birth were associated with higher rates of attendance.

• Non-Hispanic black race and ethnicity and public insurance were associated with lower attendance.

Keywords

hypertensive disorders of pregnancy - gestational hypertension - preeclampsia - postpartum follow-up - blood pressure

Note

Each author has indicated that she has met the journal's requirements for authorship. This study was presented as a poster at the 41st Annual Meeting of the Society for Maternal-Fetal Medicine, Virtual meeting, January 25–30, 2021.

Publication History

Received: 11 January 2021

Accepted: 04 October 2021

Article published online:
14 November 2021

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