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Poster Session 2

Category: Hypertension

Poster Session 2

(598) Recurrence of hypertensive disorders of pregnancy: a longitudinal study of live births in California, 2016-2021

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Meralis V. Lantigua-Martinez, MD

MFM Fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
New York, New York, United States

Coauthor(s)

RB

Rebecca J. Baer, MPH

Research Analyst
UCSF
San Francisco, California, United States
SO

Scott P. Oltman, MS

Epidemiologist
UCSF
San Francisco, California, United States
LJ

Laura Jelliffe-Pawlowski, MS, PhD

Professor
NYU
New York, New York, United States
Justin S. Brandt, MD (he/him/his)

Associate Professor, Division Director, Fellowship Program Director
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
New York, New York, United States

Objective:
To assess the recurrence risk of hypertensive disorders of pregnancy (HDP), identify risk factors associated with recurrent HDP (R-HDP), and quantify the impact of gestational age of delivery in the para 1 (P1) pregnancy on R-HDP and associated preterm birth (PTB) in their para 2 (P2) pregnancy.

Study Design:
We performed a longitudinal study of pregnant people with consecutive liveborn singleton births in California (2016-2021) using birth certificates linked to hospital discharge records. We included subjects who had HDP in their P1 pregnancies. Demographic and obstetric risk factors for R-HDP were calculated using Poisson regression models as was associated PTB. The risk of R-HDP was also evaluated by gestational age of delivery in P1 pregnancies. Models were adjusted for demographic and obstetric factors.

Results:
During the study period, there were 20,166 people with HDP in P1 pregnancies who had subsequent linked P2 pregnancies. The overall recurrence rate of HDP was 30.5%; recurrence varied by type of HDP in P1 pregnancy, ranging from 27% for gestational hypertension to 45% for superimposed preeclampsia. Among people with HDP in P1, the risk of R-HDP was higher for people with advanced maternal age compared to age 18-34 (relative risk [RR] 1.2, 95% confidence interval [CI] 1.1,1.3), drug or alcohol use compared to none (RR 1.8, 95% CI 1.6,2.0), housing instability compared to stable housing (RR 2.1, 95% CI 1.1,4.1), and mental health conditions compared to none (RR 1.5, 95% CI 1.4,1.6) (Table 1). In the analysis of risk of R-HDP by gestational age of delivery in P1 pregnancies, we found the highest risk of R-HDP and PTB < 34 weeks occurred in people with PTB prior to 28 weeks in their index pregnancies (adjusted RR 13.3, 95% CI 4.7,37.7) and remained elevated for any history of PTB with HDP (adjusted RR 7.9, 95% CI 5.6,11.1) (Table 2).

Conclusion:
The recurrence rate of HDP and associated PTB varies by severity of HDP and gestational age at delivery in the index pregnancy. Further prospective studies on mitigating modifiable risk factors are needed to design targeted preventative interventions.