(860) Maternal Postpartum Blood Pressure Prior to Delivery Discharge and Risk of Hospital Readmission.

Secondary analysis of all patients enrolled in the Chronic Hypertension and Pregnancy trial. Patients who had a miscarriage, were lost to follow-up, or were missing BP measurements during delivery hospitalization were excluded. The primary outcome was postpartum readmission. Characteristics and outcomes were compared between those who had a mean BP < 140/90 prior to discharge versus those with mean BP ≥140/90. Logistic regression was used to control for significant covariates.

Results:
Of 2,223 eligible patients, 1,554 (70%) had mean pre-discharge BPs < 140/90 and 669 (30%) had mean BP ≥ 140/90. Patients who had mean BP ≥140/90 were more likely to be Black, have had a cesarean and delivered earlier, use antihypertensive medications at discharge, and experience longer delivery hospitalization (Table 1). Patients with controlled BPs had 104 total readmissions (6.7%) with average length of stay (LOS) 3.7 days, whereas those with uncontrolled BPs had 52 readmissions (7.8%) with average LOS 3.3 days, though the difference in readmission rate was not statistically significant (Table 2). Further, there were no differences in rates of severe maternal morbidity or readmission length between the two groups.

Conclusion:

Higher postpartum BPs just prior to discharge were not associated with significantly increased rates of hospital readmission in patients with mild CHTN, even though these patients did have worse delivery outcomes. Higher use of antihypertensives in the those with higher BPs likely mitigated the risk of hospitalizations.