| dc.description.abstract |
<p>Background: The burden of cardiovascular disease (CVD) is rising in sub-Saharan
Africa (SSA). Preeclampsia, a type of hypertensive disorder of pregnancy, is a unique
risk factor for CVD among women, yet little is known about the postpartum cardiovascular
risk among women with preeclampsia in SSA. Objective: To determine the incidence of
hypertension, a major risk factor for CVD, at 6-months postpartum among Kenyan women
with preeclampsia. Methods: This prospective cohort study included all pregnant or
recently postpartum women with preeclampsia who were admitted to a national, referral
hospital in western Kenya from January 20, 2020-March 19, 2020, when the study was
unexpectedly paused due to the COVID-19 pandemic. Using home blood pressure monitoring
technique, we described the trajectory of blood pressure after delivery. Bivariate
and multivariable regression analyses were performed to investigate for risk factors
associated with hypertension at 6-month follow-up. Results: Eight-six women with preeclampsia
were enrolled prior to March 19, 2020, when the study was unexpected paused due to
the COVID-19 pandemic. Among the 50 women who completed follow up, 38% (n=19) had
hypertension. Blood pressure normalized for all women by 6 weeks after delivery but
rose again beyond 12 weeks among those with hypertension at follow up. Maternal age,
parity and history of preeclampsia in prior pregnancy or a previous pregnancy complication
(preterm delivery or stillbirth) were associated with hypertension at follow up. Overall,
rates of routine, postpartum clinic follow up were low (64%) among women despite nearly
all (97%) attending clinic for infant immunizations following delivery. Conclusion:
There is a high incidence of hypertension at 6-months postpartum among Kenyan women
with preeclampsia, though low rates of postpartum follow up care indicate a potential
missed opportunity for early CVD identification and prevention among this high risk-population.
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