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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Hypertension

Poster Session 3

(779) Risk of recurrent severe hypertensive disorders of pregnancy

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Prior studies have reported different recurrence rates for severe hypertensive disorders of pregnancy (HDP). We sought to assess the recurrence risk of severe HDP (sHDP) in a nationwide cohort.

Study Design:
Retrospective cohort study using the Premier Inpatient database. We identified 560,295 individuals with ≥2 observed pregnancies between 10/2015 and 12/2020. The risk and relative risk (RR) of sHDP, defined as preeclampsia with severe features, HELLP syndrome, or eclampsia, in a subsequent pregnancy, was estimated based on HDP in index pregnancy. The risk of sHDP by gestational age and the risk of each subtype of sHDP (any severe features, HELLP, or eclampsia) was also estimated.

Results:

Of those with ≥2 pregnancies, mean age was 27.2±5.3 years, 14.1% were Black, and 3.3% had class III obesity. 57,584 (10.3%) had HDP and 11,433 individuals (2.0%) had sHDP in the index pregnancy; 1,703 (14.9%) experienced recurrent sHDP in a subsequent pregnancy. Tables 1 and 2 show the risk of subsequent sHDP by timing and severity of HDP in the index pregnancy. Compared to those with no HDP in the index pregnancy, those with sHDP at any gestational age had an increased risk of sHDP in a subsequent pregnancy (14.9%, RR 16.0, 95%CI 15.2-17.0); those with a history of sHDP < 28 weeks’ gestation had the highest risk (22.9%, RR 23.1, 95%CI 19.1-27.9). sHDP < 28 weeks conferred the highest risk of recurrence at < 28 weeks (RR 184.9, 95%CI 107.2-318.9), but the absolute risk was low (4.71%). Those with a history of HELLP or eclampsia had elevated risk of sHDP (11.5%, RR 9.7, 95%CI 8.3-11.3 and 11.0%, RR 9.2 95%CI 7.2-11.75 respectively), including recurrence of HELLP (4.6%, RR 61.0 95%CI 46.2-80.6) and eclampsia (1.1%, RR 40.1 95%CI 16.3-98.3), but these phenotypes occurred infrequently.

Conclusion:

The risk of recurrent sHDP is lower than previously reported and is influenced by the severity and timing of HDP in the index pregnancy, with the highest recurrence seen among those with early onset sHDP. These results inform counseling about risk of future sHDP to aid patients in reproductive decision-making.