Search Results for: Linee guida sull’emorragia postpartum

Circulation, Volume 150, Issue Suppl_1, Page A4134379-A4134379, November 12, 2024. Introduction:Mediterranean-style diet (MSD) is associated with a lower risk of cardiovascular and metabolic diseases. However, the association of MSD during pregnancy with adverse pregnancy outcomes (APOs) among different racial and ethnic groups and overweight or obesity (OWO) status remains unclear.Question:We examined if MSD during pregnancy is protective for developing any APO and individual APOs in a large cohort of racially and ethnically diverse, urban, low-income women.Methods:Among 8,511 patients in the Boston Birth Cohort (mean age 28.2±6.5 yrs), 47% were non-Hispanic Blacks and 28% were Hispanics. Among 4,343 (51%) with pre-pregnancy OWO status, 25% Black and 12% Hispanic women developed any APO (Figure 1). Individual Mediterranean-style diet score (MDS) was based on maternal diet intake during pregnancy via food frequency questionnaire interviews at 24-72 hours postpartum.Results:Increase in the MDS by one standard deviation was inversely associated with any APO (aOR, 0.86 [95% CI, 0.82–0.90]), preeclampsia or eclampsia or HELLP (aOR, 0.89 [95% CI, 0.82–0.97]), gestational diabetes (aOR, 0.88 [95% CI, 0.81–0.95]), preterm birth (aOR, 0.90 [95% CI, 0.86–0.95]), and low birth weight (aOR, 0.87 [95% CI, 0.83–0.92]) (Table 1). In the subgroup analysis, higher adherence to MSD was associated with lower odds of developing, preeclampsia or eclampsia or HELLP, low birth weight, and preterm birth in Black women with or without OWO. The benefit of MDS was also observed for gestational diabetes in Hispanic women with OWO (Figure 2).Conclusion:Greater adherence to MSD during pregnancy is associated with a lower risk of composite APOs, with benefits varying across types of APOs, racial/ethnic groups, and OWO status.

Circulation, Volume 150, Issue Suppl_1, Page A4141054-A4141054, November 12, 2024. Introduction:Physiologic changes in pregnancy can accentuate valvular pathologies. The modified WHO pregnancy risk classification categorizes severe mitral stenosis (MS) as mWHO Risk Class IV in which pregnancy is contraindicated. Literature on the management of MS in pregnancy is limited to rheumatic heart disease. Those that are non-rheumatic in nature are therefore difficult to characterize. To better understand these differences in management, we present a case of MS from pannus-overgrowth 10 years after bioprosthetic valve placement.Our Case:A 29-year-old primigravid female, with a history of traumatic rupture of the posterior papillary muscle managed by a 25mm Carpentier-Edwards bioprosthetic mitral valve was seen at 13-weeks. A multidisciplinary (MDC) meeting was held with maternal-fetal medicine (MFM) and cardiothoracic surgery. A TEE confirmed severe MS [MVA 1.3cm2, mean gradient 19.5 mmHg, and peak velocity of 2.6 m/s] as the result of pannus-overgrowth limiting mobility in 1/3 leaflets. She was not a candidate for balloon valvuloplasty given her bioprosthetic valve, or valve replacement due to the risks cardiopulmonary bypass. She opted to continue pregnancy with medical management. As expected, in the mid-second trimester blood pressure reached its nadir, and her heart rate increased; therefore, metoprolol was started. Exposure to β-blockers is associated with fetal growth restriction (FGR) and the MFM team performed serial growth ultrasounds for close monitoring. At 28-weeks, she developed dyspnea, and the β-blocker dose was titrated. At 32-weeks these symptoms worsened, and furosemide was started. She experienced palpitations, but remote cardiac monitoring was reassuring. The pregnancy was complicated by non-severe FGR and so the MDC decided to pursue a medically indicated planned vaginal delivery in the intensive care unit (ICU) at 35-weeks. Delivery was accomplished via assisted second stage of labor to avoid maternal Valsalva. The postpartum course was uncomplicated. As she desired future childbearing, she underwent successful mechanical valve replacement after 3-months.Discussion:For pregnant patients with MS, heart rate and volume optimization are of critical importance. β-blockers and diuretics are safe and effective in pregnancy and providers should initiate these therapies as needed. We highlight the importance of an MDC approach in patients with MS and confirm that pregnancy and vaginal delivery can be safe.

Circulation, Volume 150, Issue Suppl_1, Page A4144539-A4144539, November 12, 2024. Introduction:Pregnancy-induced cardiomyopathy is typically idiopathic, with no predisposing condition identified. In some cases, women with pre-existing genetic mutations may initially present with cardiomyopathy in pregnancy.Case:A 30-year-old G2P1001 woman presented to Labor&Delivery with frequent palpitations, dyspnea on exertion, and reduced exercise tolerance in the third trimester. Her previous pregnancy was complicated by frequent premature ventricular contractions (PVCs) but otherwise unremarkable. She had a family history of early-onset atrial fibrillation in her mother and a maternal cousin with pregnancy-induced arrhythmias. ECGs and telemetry demonstrated significant ectopy (bigeminy, non-sustained ventricular tachycardia) and atrial arrhythmias including supraventricular tachycardia, atrial tachycardia, and atrial fibrillation (Figure 1). Transthoracic echocardiogram (TTE) showed an ejection fraction (EF) of 20-25%, reduced from 50% 2 weeks prior. Ectopy was associated with reduced fetal heart rate variability suggestive of fetal malperfusion, for which an urgent C-section was performed at 38 weeks and 6 days. Following delivery, she was started on amiodarone, metoprolol, and spironolactone, as part of guideline-directed medical therapy. Subsequent TTEs showed improvement in EF to 30-35% at 2 days and 45-50% at 4 weeks postpartum. Cardiac MRI showed no evidence of fibrosis or inflammation. Given her maternal family history of arrhythmic events, genetic testing was pursued. Genetic testing revealed a pathogenic SCN5A variant (c.638G >A (p.Gly213Asp)).Discussion:SCN5A variants are associated with dilated cardiomyopathy, conduction disorder, and arrhythmias. It is a rare variant of pregnancy-induced cardiomyopathy. This case highlights the value of genetic testing in patients with significant arrhythmia burden and cardiomyopathy in pregnancy and a family history of cardiomyopathy and arrhythmias. For pregnant women with genetic variants predisposing to arrhythmias and cardiomyopathy, comprehensive longitudinal, multidisciplinary care is essential at a referral center with Cardio-Obstetrics expertise and an Inherited Heart Disease Clinic.

Circulation, Volume 150, Issue Suppl_1, Page A4146404-A4146404, November 12, 2024. Background:Pregnancy poses physiologic changes that can precipitate severe or fatal cardiovascular events among women with hypertension (HTN). Understanding mechanisms by which delivery might contribute to these events in women with HTN is critical for prevention.Aims:To examine trends in markers of cardiac wall strain or inflammation measured via N-terminal pro b-type natriuretic peptide (NTproBNP) and high-sensitivity C-reactive protein (hs-CRP) in pregnancies with and without HTN.Methods:In a prospective, 1:1 case-control design, we enrolled pregnant women with and without HTN between 24-32 weeks gestation (2019-2022). HTN was defined by a clinician diagnosis of chronic or gestational HTN or a baseline blood pressure (BP) ≥140/90 mm Hg. The control group (no HTN) had a systolic BP

Circulation, Volume 150, Issue Suppl_1, Page A4147594-A4147594, November 12, 2024. Background:Mental health issues, preeclampsia, and eclampsia were among the leading causes of pregnancy-related deaths from 2018-2020 in Georgia. Studies from other countries have suggested that self-measured blood pressure (SMBP) among pregnant and postpartum women is a feasible method for reducing the risk for hypertension-related pregnancy complications (e.g., preeclampsia, eclampsia). Long-term risks of CV issues during pregnancy are known to increase the risk of stroke and heart attack later in life. Despite the benefits of SMBP, its impact is understudied among at-risk women during and after pregnancy. Therefore, we aimed to explore if incentives are associated with an increase in blood pressure (BP) reporting among pregnant and postpartum women utilizing the VidaRPM application.Methods:91 women (67.5% HS or less, 58.8% Black, Mean Age = 27.01y) were randomized to the control (usual care, n=30), regular (SMBP through VidaRPM, n=30), or incentivized (SMBP with incentives, n=31). All women were between 13 and 34 weeks of pregnancy. All participants received a blood pressure monitor, and online education resources, and were asked to record BP three times a week and one mental health survey a week during pregnancy until the 12thweek postpartum. Regular SMBP participants received additional education, self-efficacy assessment, and ongoing support. Incentive participants received an additional $25 gift card for full engagement between 34 weeks of pregnancy and 6 weeks postpartum. Women who reported BP outside the normal range were instructed to follow up with their providers.Results:Moms in the Control Group had full engagement for 5 out of 304 weeks, regular SMBP arm for 56 out of 245 weeks, and Incentive arm, for 76 out of 254 weeks. The difference among all three groups is statistically significant (p-value = 9.7e-15) however the difference between the two treatment groups is not.Discussion:The incentive and regular SMBP groups demonstrated significantly increased adherence to reporting compared to control, and the incentive group more than regular group. This result supports incentivized SMBP during and after pregnancy, possibly reducing missed hypertensive issues and reducing the risk of unmonitored long-term cardiovascular outcomes. Improving women’s self-efficacy and knowledge of risk among at-risk populations will positively impact short and long-term CV health.

Circulation, Volume 150, Issue Suppl_1, Page A4145402-A4145402, November 12, 2024. INTRODUCTION:Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure, which occurs late in pregnancy or within the first 5 months postpartum and it is the most common cause of death related to heart failure in pregnant women. To establish the diagnosis, other causes of heart failure must be ruled out and a left ventricular ejection fraction (LVEF)

Circulation, Volume 150, Issue Suppl_1, Page A4143849-A4143849, November 12, 2024. Background:Maternal mortality in the United States continues to rise, with hypertensive disorders of pregnancy (HDP) playing a significant role in adverse outcomes. Patients of color have worse outcomes compared to their White counterparts. Data in non-pregnant patients suggests community health workers (CHWs) can help mitigate disparities and improve HDP outcomes. Does exposure to a CHW improve patient education about HDP and satisfaction and are these findings different between Black and non-Black patients?Methods:This was a prospective survey study that enrolled patients delivering at the University of Chicago (UCM). Patients with HDP are automatically enrolled in a standardized postpartum hypertension education program (STAMPP-HTN) where they receive education and a blue tooth compatible blood pressure monitor. Patients who did not record their blood pressures were contacted by a CHW and surveyed about their experience. Results were compared between Black and Non-Black patients using a Wilcoxon Rank Sum, X2or Fisher’s Exact test, as appropriate.Results:There were 32 survey responses from 22 respondents and 15 patients with complete baseline data, 6 of whom were Black and 9 of whom were non-Black. There were no differences in age, insurance status, or pregnancy outcomes between groups. Additionally, of the 32 survey responses, there were no significant differences in experiences with a CHW between Black and non-Black patients. Table 1 outlines the impact of CHW on patient’s education and attitude towards HDP. Most patients found that CHW involvement increased the amount of time they checked their blood pressure (76%) with no difference between races (p=0.23). Overall, 84% patients (strongly agreed or agreed) that their CHW knows the important issues about their healthcare.Conclusion:The incorporation of a CHW program into a pre-existing postpartum hypertension program was overall well-received by patients with no racial disparity. The program increased the patient’s understanding of HDP and lead to a better follow up of their blood pressures values. Further work is needed to determine how this program impacts long-term patient’s outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4147241-A4147241, November 12, 2024. Background:Prior studies suggest that angiogenic markers measured during pregnancy may be associated with higher future systolic blood pressure. Furthermore, prior work suggests postpartum body mass index (BMI) influences progression to chronic hypertension among women who experience hypertensive disorders of pregnancy. However, no studies to date have investigated the relationship between levels of angiogenic markers during pregnancy and the future development of obesity among non-obese pregnant women.Methods:We included participants in a longitudinal pregnancy biorepository at Brigham and Women’s Hospital (Boston, MA) who had available levels of sFlt-1 (soluble fms-like tyrosine kinase receptor-1) and PlGF (placental growth factor) measured in the third trimester and who continued to follow with primary care in one of the Mass General Brigham institutions up to December 2019, with available covariate and outcome data. We excluded participants with a pre-pregnancy history of obesity (BMI ≥30 kg/m2). The ratio of sFlt-1/PlGF in the third trimester was examined by tertiles. Adjusted mixed effects models were used to test group differences in BMI trends during follow-up.Results:Among 590 participants included, the mean (SD) first-trimester BMI was 24 (3) kg/m2, and the mean age at delivery was 32 (6) years. Maternal age at delivery and first-trimester BMI were similar across sFlt-1/PlGF tertiles, but participants in the higher tertiles tended to have a slightly lower gestational age at delivery (Table 1). During a median follow-up of 9 years, 173 participants (29%) developed obesity during follow-up. Participants in the second and third tertiles had steeper increases in BMI (+0.22 and +0.24 kg/m2, respectively) compared to those in the first tertile (+0.18 kg/m2; p

Circulation, Volume 150, Issue Suppl_1, Page A4144055-A4144055, November 12, 2024. Background:Maternal cardiovascular health is a critical concern, particularly during and following pregnancy. Previous studies have highlighted the influence of social determinants on health outcomes, but the specific impact of adverse Physical Environment, Housing, and Economic Conditions on maternal cardiovascular health remains underexplored.Methods:Using the TriNetX global health research network within the US Collaborative Network, we explored how adverse Physical Environment, Housing, and Economic Conditions (ICD10CM: Z58 and ICD10CM: Z59) impact maternal cardiovascular health during pregnancy and within one year postpartum. Using, propensity score matching (PSM) analysis, our study compared two cohorts: women aged 15 to 60 who experienced issues related to Physical Environment, Housing, and Economic Conditions during or after pregnancy from 2008 to 2023, and women in the same age range who did not face such issues, thus representing a favorable physical environment, housing, and economic conditions.Results:Challenges related to the physical environment, housing, and economic conditions significantly increased the risk of all-cause mortality (OR: 3.237, 95% CI: 2.064 to 5.075, p

Circulation, Volume 150, Issue Suppl_1, Page A4139708-A4139708, November 12, 2024. Background:Racial and ethnic disparities exist in cardiovascular health (CVH) in pregnancy. While social determinants of health (SDOH) affect CVH, the extent to which SDOH assessed in early pregnancy explain racial and ethnic differences in CVH postpartum remains to be defined.Objective:This study examines the relative contribution of SDOH in early pregnancy to racial and ethnic differences in maternal CVH 2-7 years after delivery.Methods:This is a secondary analysis of the prospective nulliparous pregnancy outcomes study: Monitoring Mothers-to-be Heart Health Study (nuMoM2b-HHS) cohort. The outcome was maternal CVH defined using the American Heart Association’s Life’s Essential 8 (LE8) framework, which included body mass index, blood pressure, lipids, fasting glucose, diet, physical activity, sleep health, and smoking status, and calculated as a score of 0-100. We used the Blinder-Oaxaca decomposition to quantify the statistical contributions of differences in demographic (age and nativity), socioeconomic status ([SES], education, income, insurance, and health literacy), and psychosocial (resilience, social support, anxiety, depression, and stress) factors in early pregnancy to differences in mean postpartum CVH between the two largest self-identified minoritized racial and ethnic groups (non-Hispanic [NH] Black and Hispanic) and NH White individuals.Results:Of 4,161 assessed pregnant individuals, 17.7% identified as Hispanic, 15% as Black, and 67.3% as White. After adjusting for demographic, SES, and psychosocial factors, the average CVH score in White individuals was 12.2 (SE 1.2) points higher (better) than in Black individuals and 3.3 (SE 0.8) points higher than in Hispanic individuals (Figure, all p

Circulation, Volume 150, Issue Suppl_1, Page A4143094-A4143094, November 12, 2024. Background:Peripartum cardiomyopathy (PPCM) is defined as a dilated form of cardiomyopathy that occurs within the last month of pregnancy and up to 5 months postpartum. The etiology is likely multifactorial and viral infections may account for up to a third of PPCM cases. We aimed to examine the impact of concurrent COVID-19 infection on in-hospital outcomes of women with PPCM.Methods:National Inpatient Sample was queried to identify women admitted with PPCM with COVID-19 (group A) between the years 2020-2021 and without (group B) concurrent COVID-19 infection between the years 2016-2019.Results:A total of 19135 women were admitted with PPCM between the years 2016-2021, of whom 420 (2%) had concurrent COVID-19 infection. Group A PPCM followed a seasonal pattern with peak incidence in fall (43%) followed by winter (31%), spring (13%) and summer (13%) [p=0.002]. Group A was more often Hispanic (20.3% -vs- 10.8%, p

Circulation, Volume 150, Issue Suppl_1, Page A4140800-A4140800, November 12, 2024. Introduction:Peripartum cardiomyopathy (PPCM) is the leading cause of late postpartum pregnancy-related death and often precipitates acute heart failure and cardiogenic shock. Limited contemporary data exists on long-term outcomes among PPCM patients who develop cardiogenic shock (PPCM-CS), especially those who require extra-corporeal membrane oxygenation (ECMO).Methods:This retrospective cohort study identified patients with PPCM-CS from January 2012-January 2024, using EHR-based data from academic medical centers across the US (TriNetX, Inc.). The primary outcome was all-cause mortality over a 180-day follow-up period. Secondary outcomes included acute kidney injury (AKI), new-onset atrial fibrillation (AF), ventricular tachycardia/fibrillation (VT/VF), mechanical circulatory support (MCS), and heart transplantation (HT). The outcomes were reported in the overall population and among those requiring ECMO support.Results:We identified 856 females (mean age 36 ± 12 years; 41% White, 41% Black individuals) with PPCM-CS (Table). During a mean follow-up of 144 ± 63 days, all-cause mortality occurred in 17.9%. There were high incidences of AKI (53.7%), AF (19.4%), and VT/VF (29.3%) (Fig 1). 8.1% of patients successfully underwent HT. There was substantial MCS use, with percutaneous ventricular assist device (pVAD) used in 8.7% and intra-aortic balloon pump (IABP) used in 11.0%. Among those requiring ECMO (N=97, 11.3%), there was high all-cause mortality (26.8%). The concomitant use of pVAD and IABP was 14.4% and 15.5%, respectively. 14.4% of ECMO-supported patients underwent successful HT.Conclusion:This study provides insights into long-term clinical outcomes among patients with PPCM-CS, highlights those requiring ECMO support. Further investigation is needed for early disease recognition and to establish optimal utilization of MCS to improve outcomes in PPCM-CS.

Circulation, Volume 150, Issue Suppl_1, Page A4141212-A4141212, November 12, 2024. Background:Premature coronary artery disease (CAD) is increasing, especially in young women. There is currently no data regarding the cardiovascular and obstetrical risk of pregnancy in patients with premature CAD.Objective:This study aims to describe the cardiovascular, obstetrical and fetal outcomes in pregnant patients with premature CAD.Methods:Using the AFIJI cohort of individuals with premature CAD (Appraisal of risk Factors in young Ischemic patients Justifying aggressive Intervention), we compared the cardiovascular outcomes of women aged < 40 years-old who experienced pregnancy versus those who did not. Major adverse cardiovascular events (MACE) including death, myocardial infarction, ischemic stroke, or unplanned revascularization were analyzed using a Cox model with pregnancy as a time-dependent variable. A secondary analysis described obstetrical and fetal outcomes in pregnant women with premature CAD vs. pregnant women of the French National maternal and fetal cohort (n=11992).Results:Among women with premature CAD in the AFIJI cohort (N = 120), 50 were aged < 40 years among whom 24 experienced pregnancy. Aspirin was the only treatment continued during pregnancy. We observed an association between pregnancy and an increased risk of cardiovascular events (aHR 3.87, IC95% 1.41-10.63, p < 0.01) adjusted for age and tobacco use. When comparing with the French National database, pregnant women with premature CAD had higher rates of preeclampsia (20.8% vs. 2.3%), pregnancy-induced hypertension (37.5% vs. 2%), threat of premature birth (20.8% vs. 4.8%), postpartum hemorrhage (12.5% vs. 3%) and fetal death (8.7% vs. 0.8%).Conclusion:Pregnancy in women with premature coronary artery disease is associated with a higher risk of major adverse cardiovascular events and significant more obstetrical complications. These findings highlight the need for careful monitoring and management of pregnant patients with a prior history of CAD to mitigate these risks.

Circulation, Volume 150, Issue Suppl_1, Page A4143844-A4143844, November 12, 2024. A 35-year-old gravida 1, para 0 with biventricular heart failure (LVEF 25%), nonischemic cardiomyopathy, history stroke, history of left ventricular thrombus, class III obesity, and chronic kidney disease who had been followed by Cardio-Obstetrics throughout her pregnancy presented at 34 weeks gestation for planned induction of labor. Upon presentation, she underwent assessment with a pulmonary artery catheter (PAC) and was noted to be in cardiogenic shock with elevated biventricular filling pressures and low cardiac index necessitating hemodynamic stabilization followed by primary cesarean section.The patient was admitted to the cardiac ICU for medical optimization prior to delivery. Home medications including isosorbide dinitrate, metoprolol, and hydralazine were continued. The patient was briefly placed on inotropic support with dobutamine, which was discontinued due to ectopy. After PAC-guided IV diuresis, anticoagulation transition from enoxaparin to heparin, and twice daily fetal monitoring via non-stress test, a multidisciplinary team, including cardiology, maternal fetal medicine, cardiac anesthesia, and cardiothoracic surgery assembled for the C-section. Following pre-delivery cannulation for potential ECMO support, the patient underwent C-section and elective salpingectomy under epidural anesthesia with delivery of a healthy neonate.Post-delivery, the patient was monitored in the ICU, focusing on fluid management, anticoagulation transition to warfarin, and titration of heart failure medications, as the patient did not plan to breastfeed. After discharge, she was scheduled for a 2-week postpartum visit including echocardiogram, EKG, and NT-proBNP.Discussion:Given the patient’s acute decompensation and fluid overload, medical optimization was essential prior to delivery. However, stabilization was expected to be temporary due to ongoing physiologic changes of pregnancy. Her limited mobility and concern for multiorgan compromise, such as new oxygen dependency and rising creatinine, made a prolonged induction of labor unfeasible. Due to concern for maternal intolerance of labor, unstable fetal lie, fetal distress due to decreased perfusion, and an increased likelihood of emergency C-section, a primary C-section was recommended as a safer option. The successful delivery of a healthy neonate and post-operative maternal stabilization highlights the importance of a multidisciplinary approach in managing complex cardio-obstetric cases.

Circulation, Volume 150, Issue Suppl_1, Page A4145391-A4145391, November 12, 2024. INTRODUCTION:Pregnancy is marked by cardiovascular and hemodynamic changes to enable normal placental-fetal growth but may also predispose women to adverse outcomes including hypertensive disorders. Studies have assessed the plasma proteome of hypertension, but proteomic biomarkers of maternal blood pressure (BP) through pregnancy and postpartum remain unexplored.OBJECTIVES:Explore the 1sttrimester (TM) maternal plasma proteome in relation to systolic (S) and diastolic (D) BP in the 1stand 3rdthird TM, and 3 months postpartum.METHODS:We obtained baseline, 1stTM plasma samples from n=435 women from an antenatal multiple micronutrient vs iron-folic acid supplement trial in rural NW Bangladesh (West et al JAMA 2014). Phlebotomy occurred

Circulation, Volume 150, Issue Suppl_1, Page A4143070-A4143070, November 12, 2024. Background:Hypertensive disorders of pregnancy (HDP) serve as the second leading cause of maternal mortality globally and represent a threat to pregnancies across our nation. Blood pressure goals and practice patterns continue to vary broadly between and within institutions. An updated analysis of the management and outcomes of HDP is necessary. The aim is to evaluate maternal and neonatal outcomes for patients admitted due to HDP at our institution.Methods:Patients (≥18 years of age) 23+0to 34+6weeks’ gestation who were hospitalized at the University of Chicago with a HDP associated condition between January 1st, 2022, and January 31st, 2024 were included in this cohort study. Demographics, maternal/neonatal events, and the correlation between interventions received during pregnancy and HDP outcomes were assessed.Results:Our study included 140 patients with HDP, of which 46 (32.9%) had preeclampsia (preE) with severe features (SF), 13 (9.3%) had preE without SF, 10 (7.1%) had gestational HTN, and 26 (18.6%) had cHTN. Our cohort was predominantly African American (n = 86; 61.4%) with median age 31 years (IQR 26, 35). Among patients with a preterm delivery (80.4%), the most common indication for delivery was persistent severe hypertension (81.1%). Modest correlations were observed between birthweight percentile and both systolic BP (Spearman r = -0.189 [95% CI: -0.368, 0.004]; p = 0.06) and diastolic BP (r = -0.197, [95% CI: -0.373, -0.002]; p = 0.047), with BP decreasing as the percentile increased. Figure 1 outlines the latency between admission date and delivery. Patients on an antihypertensive medication at the time of postpartum discharge were less likely to be readmitted within six weeks (9.0% vs 22.0%; p = 0.03) due to BP control as compared to patients who were not on medication.Conclusion:This study demonstrates that severe HTN feature of HDP is most associated with neonatal adverse outcomes and maternal postpartum readmissions. Patients with HDP can benefit from an improved stratification tool during antepartum and at discharge to identify patients at higher risk of neonatal/maternal adverse outcomes.