Proteinuria in hypertensive pregnancy diseases is associated with a longer persistence of hypertension postpartum

Abstract

As there is growing evidence that hypertensive pregnancy disorders are associated with a risk of cardiovascular diseases later, the resolution of hypertension postpartum (PP) is of high clinical significance. However, there is little knowledge about the factors that influence this normalization. The objectives of our study were (a) to investigate whether or not there are differences in the resolution of hypertension between the distinct types of hypertensive pregnancy disorders and (b) to analyse what clinical parameters may determine the resolution pattern PP. In this retrospective study, 52 patients with preeclampsia (PE), seven with HELLP syndrome (haemolysis, elevated liver enzymes, low platelets), 10 with chronic hypertension (CH) and 21 with pregnancy-induced hypertension (PIH) were recruited. The course of the clinical parameters until day 7 PP was documented. Patients with proteinuria (PE/HELLP) showed the highest blood pressure values PP, while patients with PIH and CH showed no blood pressure changes up to day 7 PP. In patients with proteinuric diseases, there was a significantly higher percentage of cases with persisting hypertension at day 3 PP (71% vs 48% PIH/CH group, P<0.05), and even at day 7 PP this percentage remained significantly higher (31% vs 19% PIH/CH group). Our study shows that patients with proteinuric pregnancy disorders have a delayed PP of hypertension. A high percentage of these women are discharged from hospital with persisting hypertension and proteinuria. These observations demand a more specific and long-term PP care for these women.