BACKGROUND AND PURPOSE:

• Sinnott et al. (Obstetrics & Gynecology, 2025) estimated the incidence of de novo hypertension up to 6 months postpartum in patients without evidence of hypertension during pregnancy or immediately postpartum

METHODS:

• Retrospective cohort study
  • Internal obstetric database at a large academic center
  • All individuals delivering between 2013 and 2022
• Population
  • Patients classified as normotensive in pregnancy and the first 6 weeks postpartum
• Exposures
  • Patient characteristics
• Study design
  • Multinomial logistic regression was performed for hypertensive status in the late postpartum period
  • Race and ethnicity were included in the adjusted model
• Primary outcome
  • Elevated BP or hypertension in the late postpartum period

RESULTS:

• 7730 patients
• Elevated BP or greater in late postpartum
  • Elevated BP: 17.9%
  • Stage 1 or 2 hypertension: 8.2%
• Patients with end-pregnancy BMI ≥30 were more likely to develop stage 1 or 2 hypertension in the late postpartum period
  • Adjusted odds ratio (aOR) 1.81 (95% CI, 1.52 to 2.15)
• Patients who were non-Hispanic Black and those with GDM experienced greater odds of late postpartum hypertension
  • Non-Hispanic Black (vs non-Hispanic White): aOR 1.42 (95% CI, 1.11 to 1.82)
  • GDM: aOR 1.34 (95% CI, 1.03 to 1.74)

CONCLUSION:

• Nearly 20% of all patients who remained normotensive through pregnancy and early postpartum developed elevated BP or higher order hypertension in the late postpartum period
  • Patients with higher odds were those with obesity | Who were non-Hispanic Black | With GDM
• Limitations of this study include retrospective design and only patients with postpartum BP data were included
• The authors state

These findings underscore the importance of optimizing the transition from obstetric care to primary care in the postpartum period and highlight the critical role that the primary care team can play in mitigating cardiovascular risk among postpartum patients

Learn More – Primary Sources:

Late-Onset Postpartum Hypertension After Normotensive Pregnancy