Postpartum Cardiovascular Health in African Women Following Pre-Eclampsia: A Prospective Cohort Study

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2025-04-28 DOI:10.1111/1471-0528.18192

Annettee Nakimuli, Emmy Okello, Annette Kesiiga, Moses Adroma, Jackline Akello, Sheila Nabweyambo, Musa Sekikubo, Imelda Namagembe, Robert Kayesubula, Ronald Galiwango, Brittany Jasper, Ashley Moffett, Catherine E. Aiken, Ian B. Wilkinson, Carmel M. McEniery

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Abstract

Objective

To investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.

Design

Prospective cohort study.

Setting

Tertiary referral hospital in urban Uganda.

Population

Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.

Methods

Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.

Main Outcome Measures

The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.

Results

At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16–1.36, p < 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, p < 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, p < 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (p = 0.35).

Conclusions

In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. Over one-third of women with pre-eclampsia developed hypertension at one year postpartum, emphasising the need for postpartum blood pressure monitoring and early intervention to mitigate long-term cardiovascular risk in this high-risk population.

Abstract Image

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.