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Understanding maternal postnatal blood pressure changes following hypertensive disorders in pregnancy : protocol for a prospective cohort study

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Sheehan, Elaine, Wang, Chao, Cauldwell, Matthew, Bick, Debra and Thilaganathan, Basky (2022) Understanding maternal postnatal blood pressure changes following hypertensive disorders in pregnancy : protocol for a prospective cohort study. BMJ Open, 12 (4). e060087. doi:10.1136/bmjopen-2021-060087

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Official URL: https://doi.org/10.1136/bmjopen-2021-060087

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Abstract

Introduction: Hypertensive disorders occur in approximately 10% of women during pregnancy. There is robust population-based data to show that women who have hypertension in pregnancy are much more likely to develop cardiovascular disease (CVD) in the postpartum period. Women with a hypertensive disorder of pregnancy (HDP) are twice more at risk of heart disease and stroke, and four times more likely to develop hypertension after birth. Two out of three women who had HDP will die from CVD. Recent evidence suggests that young women with HDP develop signs of CVD in the immediate postpartum period, rather than several decades later as previously presumed. If confirmed, this concerning finding presents healthcare practitioners with an opportunity to influence women’s cardiovascular health by advising on lifestyle choices and considering therapeutic interventions to prevent the development of CVD. Methods and analysis: This prospective cohort study design will ask approximately 300 participants to complete 3 days of home blood pressure monitoring every fortnight for 12 weeks postpartum and will culminate with a 24-hour episode of ambulatory blood pressure monitoring at 12 weeks postpartum. Women and healthcare professionals will complete questionnaires surrounding postpartum care for women who had HDP and knowledge of CVD risk. In addition, the relationship between hypertension and factors likely to influence outcomes such as severity of HDP, maternal age, body mass index and ethnicity will be analysed using logistic regression. Blood pressure and data from questionnaires will be analysed using descriptive statistics, with temporal stratification. Ethics and dissemination: Research ethics approval was obtained from London-West London & GTAC Research Ethics Committee. Research outputs will be published and disseminated through midwifery, obstetric or general practitioner targeted academic journals. The patient and public involvement group will disseminate findings to women who have experienced HDP among their peer groups. Trial registration number: NCT05137808.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Hypertension in pregnancy, Cardiovascular diseases in pregnancy, Postnatal care
Journal or Publication Title: BMJ Open
Publisher: BMJ Publishing Group
ISSN: 2044-6055
Official Date: 1 April 2022
Dates:
DateEvent
1 April 2022Published
9 February 2022Accepted
Volume: 12
Number: 4
Article Number: e060087
DOI: 10.1136/bmjopen-2021-060087
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
NIHR301587[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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