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Postnatal health and care following hypertensive disorders in pregnancy: a prospective cohort study (BPiPP study)
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BPiPP study group (Including: Ashworth, Danielle C., Bowen, Liza, Maule, Sophie P., Seed, Paul T., Green, Marcus, Bick, Debra and Chappell, Lucy C.). (2022) Postnatal health and care following hypertensive disorders in pregnancy: a prospective cohort study (BPiPP study). BMC Pregnancy and Childbirth, 22 (1). 286. doi:10.1186/s12884-022-04540-2 ISSN 1471-2393.
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Official URL: https://doi.org/10.1186/s12884-022-04540-2
Abstract
Introduction: One in 10 women have hypertensive disorders in pregnancy (HDP) and are at risk of adverse short- and long-term health outcomes, yet there is limited information on their postnatal health and care needs. This study aimed to look at postnatal physical and psychological morbidity in women with HDP, compared to women without HDP, and the postnatal care received in both groups. Methods: Within a prospective cohort study, women with and without HDP were identified and recruited on the postnatal ward of 17 maternity units across England and invited to complete a short baseline questionnaire. At 3 months postpartum, women were sent a follow-up questionnaire, with reminders. The principal outcomes were the mean score at 3 months for the Edinburgh Postnatal Depression Scale (EPDS) and the EuroQol Group 5-dimension (EQ-5D) scale. Results: One thousand eight hundred twenty-nine women agreed to participate. Of these, 1757 (96%) completed the baseline questionnaire: 769 (44%) women had HDP and 988 (56%) women did not. Despite a difference in health-related quality of life and symptoms of depression at baseline between the two groups, at 3 months postnatal, within the 653 women who completed their follow-up questionnaire (37.2% of those who completed the baseline questionnaire) there were no significant differences between the groups (median EQ-5D VAS: 85 in women with HDP, 85 in women without HDP, p = 0.99 and mean EPDS score 5.5 in women with HDP, 5.0 in women without HDP, p = 0.80). Overall levels of physical postnatal morbidity were high, with 89% reporting one or more morbidities. Approximately 9% of women were re-admitted within 3 months after birth, higher in the HDP group (13.1%) higher compared to women without HDP (5.5%; RR 2.41; 95% CI 1.44–4.05). Conclusion: Overall levels of physical and psychological morbidity were high in this postnatal population. Although there were increased needs of women with HDP in the immediate postnatal period (compared to other women), their health assessments were similar at 3 months. This study highlights the unmet needs of women in the postnatal period, in addition to a missed opportunity to influence future pregnancies and improve the longer-term health of women and their babies.
Item Type: | Journal Article | |||||||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | |||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | |||||||||
Library of Congress Subject Headings (LCSH): | Hypertension in pregnancy, Pregnancy -- Complications, Postnatal care, Hypertension | |||||||||
Journal or Publication Title: | BMC Pregnancy and Childbirth | |||||||||
Publisher: | BioMed Central | |||||||||
ISSN: | 1471-2393 | |||||||||
Official Date: | 5 April 2022 | |||||||||
Dates: |
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Volume: | 22 | |||||||||
Number: | 1 | |||||||||
Article Number: | 286 | |||||||||
DOI: | 10.1186/s12884-022-04540-2 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 27 April 2022 | |||||||||
Date of first compliant Open Access: | 27 April 2022 | |||||||||
RIOXX Funder/Project Grant: |
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