@article{b052e413b70a4b36992db6a8566149b2,
title = "Persistent hypertension at 3 months postpartum among women with hypertensive disorders of pregnancy at a tertiary hospital in Southwestern Uganda",
abstract = "BACKGROUND: Hypertension is a key contributor to the global epidemic of cardiovascular disease and is responsible for more deaths worldwide than any other cardiovascular risk factor. Hypertensive disorders of pregnancy, of which preeclampsia and eclampsia are the most common forms, have been shown to be a female-specific risk factor for chronic hypertension. OBJECTIVE: This study aimed to determine the proportion and risk factors for persistent hypertension at 3 months after delivery among women with hypertensive disorders of pregnancy in Southwestern Uganda. STUDY DESIGN: This was a prospective cohort study of pregnant women with hypertensive disorders of pregnancy admitted for delivery at Mbarara Regional Referral Hospital in Southwestern Uganda from January 2019 to December 2019; however, women with chronic hypertension were excluded from the study. The participants were followed up for 3 months after delivery. Participants with a systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg or receiving antihypertension therapy at 3 months after delivery were considered to have persistent hypertension. Multivariable logistic regression was used to determine independent risk factors associated with persistent hypertension. RESULTS: A total of 111 participants with hypertensive disorders of pregnancy diagnosed at hospital admission were enrolled with a follow-up rate of 49% (54/111) at 3 months after delivery. Of these women, 21 of 54 (39%) had persistent hypertension 3 months after delivery. In the adjusted analyses, an elevated serum creatinine level (>106.08 µmol/L [≤1.2 mg/dL]) at admission for delivery was the only independent risk factor for persistent hypertension at 3 months after delivery (adjusted relative risk, 1.93; 95% confidence interval, 1.08–3.46; P=.03), controlling for age, gravidity, and eclampsia. CONCLUSION: Approximately 4 of 10 women presenting with hypertensive disorders of pregnancy at our institution remained hypertensive 3 months after delivery. Innovative strategies are needed to identify these women and provide long-term care to optimize blood pressure control and reduce future cardiovascular disease after hypertensive disorders of pregnancy.",
keywords = "Mbarara, Uganda, hypertension, hypertensive disorders of pregnancy, persistent hypertension, postpartum, preeclampsia",
author = "Lugobe, {Henry Mark} and Musa Kayondo and Mceniery, {Carmel M.} and Catov, {Janet M.} and Wilkinson, {Ian B.} and Wylie, {Blair J.} and Vaught, {Arthur J.} and Rose Muhindo and Boatin, {Adeline A.}",
note = "Funding Information: This research was supported, in part, by the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre (BRC-1215-20014). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Funding Information: The authors would like to appreciate the research assistants Ms Patience Naiga, Ms Florida Tusiimiraho, Dr Daphine Kibanda, Dr Ruth Grace Kakoba, and Dr Twesigomwe Godfrey. We acknowledge the staff at the maternity ward of Mbarara Regional Referral Hospital, Mbarara University of Science and Technology, and all the study participants. We give special thanks to the members of the training advisory committee of Mbarara University Research Training Initiative for the guidance offered during the study. Research reported in this publication was supported by the Fogarty International Center and cofounding partners (National Institutes of Health [NIH] Common Fund, Office of Strategic Coordination, Office of the Director; NIH Office of AIDS Research, Office of the Director; National Institute of Mental Health; and National Institute of Neurological Disorders and Stroke) of the NIH under award number D43TW010128 to H.M.L. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. H.M.L. is funded by the Commonwealth Trust. The research reported here was funded by the Commonwealth Scholarship Commission and the Foreign, Commonwealth and Development Office in the UK to HML. I am grateful for their support. All views expressed here are those of the author(s) not the funding body. Funding Information: The research reported here was funded by the Commonwealth Scholarship Commission and the Foreign, Commonwealth and Development Office in the UK to HML. I am grateful for their support. All views expressed here are those of the author(s) not the funding body. Funding Information: H.M.L. is funded by the Commonwealth Trust. Funding Information: Research reported in this publication was supported by the Fogarty International Center and cofounding partners (National Institutes of Health [NIH] Common Fund, Office of Strategic Coordination, Office of the Director; NIH Office of AIDS Research, Office of the Director; National Institute of Mental Health; and National Institute of Neurological Disorders and Stroke) of the NIH under award number D43TW010128 to H.M.L. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} 2023 The Authors",
year = "2023",
month = feb,
doi = "10.1016/j.xagr.2023.100163",
language = "English (US)",
volume = "3",
journal = "AJOG Global Reports",
issn = "2666-5778",
publisher = "Elsevier Inc.",
number = "1",
}