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| Risk factors of the postpartum chronic hypertension of women with hypertensive disorder of pregnancy and the prediction model establishment |
| 1. Xianyang Hospital, Yan 'an University, Xianyang, Shaanxi Province, 712000; 2. Shaanxi Aerospace Hospital, Xianyang, Shaanxi Province |
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Abstract To explore the risk factors of the postpartum chronic hypertension of women with hypertensive disorder of pregnancy (HDP), and to analyze the value of the risk factors for the HDP of the women. Methods: The clinical data of 138 pregnant women with HDP who had been antenatal examination and had given birth in the hospital from January 2019 to August 2021 were selected retrospectively. According to whether the chronic hypertension occurred of the women within 2 years after delivery, the women were divided in group A (women with postpartum chronic hypertension) and group B (women without postpartum chronic hypertension). The univariate and multivariate analysis were used to explore the influencing factors of the postpartum chronic hypertension of the women with HDP, and a prediction model was constructed. Results: The incidence of the chronic hypertension of 138 pregnant women with HDP within 2 years after delivery was 32.6% (45 cases), and among them, there were 93 cases in group B, accounting for 67.4%. Univariate analysis showed that the age, and the values of pre-pregnancy body mass index (BMI), maximum systolic blood pressure during pregnancy, neutrophil/lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) of the women with HDP were all associated with their postpartum chronic hypertension (P<0.05). Multivariate analysis showed that the age ≥35 years old (OR=1.743, 95%CI 1.072-2.834), the body mass index value ≥24 kg/m2 (OR=1.937, 95%CI 1.146-3.275), and the highest peak systolic blood pressure during pregnancy (OR=1.044, 95%CI 1.006-1.083), the NLR value (OR=2.122, 95%CI 1.351-3.335), the LMR value (OR=1.048, 95%CI 1.022-1.075) and the PLR value (OR=1.570, 95%CI 1.045-2.358) of the women with HDP were the independent risk factors of their postpartum chronic hypertension (P<0.05). Hosmer-Lemsshow goodness of fit test was χ2=9.476, DF=8, P=0.304, suggesting a good fit of the model. Receiver operating characteristic curve analysis showed that the area under the curve of the prediction model for predicting the postpartum chronic hypertension of the women was 0.859 (95%CI 0.787-0.930, P<0.001), and when the Youden index was 0.574, the sensitivity and the specificity of the prediction model for predicting the postpartum chronic hypertension of the women were 77.8% and 79.6%. Conclusion: The incidence of the postpartum chronic hypertension of the women with HDP is high, and the influencing factors of which including the age, and the values of pre-pregnancy BMI, maximum systolic blood pressure during pregnancy, NLR, LMR and PLR. The Logistic regression model based on these influencing factors has reliable predictive value for the postpartum chronic hypertension of the women.
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