Table 2.
Diagnosis, treatment and blood pressure of the hypertensive cohort by case definition
| Hypertensive cohort | Pregnancies Meeting Each Hypertension Case Criterion* | |||||||
|---|---|---|---|---|---|---|---|---|
| High BP | Treated chronic Hypertension | Rapid Treatment | ||||||
| n= 27,049 | n=24,140 | n=5,409 | n=5,363 | |||||
| n | % | n | % | n | % | n | % | |
| Received a hypertension diagnosis during pregnancy | 19,298 | (71.3) | 16,581 | (68.7) | 5,140‡ | (95.0) | 5,363 | (100.0) |
| First diagnosis recorded prior to 20 weeks† | 8,938 | (33.0) | 6,602 | (27.4) | 4,647 | (85.9) | 4,056 | (75.6) |
| First diagnosis recorded after 20 weeks | 10,360 | (38.3) | 9,979 | (41.3) | 493 | (9.1) | 1,307 | (24.4) |
| At the delivery hospitalization§ | 16,039 | (59.3) | 13,754 | (57.0) | 4,397 | (81.3) | 4,679 | (87.2) |
| Filled antihypertensive medications during pregnancy | 9,762 | (36.1) | 7,498 | (31.1) | 4,472 | (82.7) | 5,362 | (100) |
| Median gestational age at first prescription (interquartile range, in weeks) | 10.4 (5.3,24.1) | 12.2 (6.1,28.4) | 6.3 (3.6, 10.3) | 11.0 (5.9,25.4) | ||||
| Visits with high BP during pregnancy¶ | ||||||||
| Anytime during pregnancy | ||||||||
| ≥1 visit with high BP | 26,355 | (97.4) | 24,140 | (100) | 4,715 | (87.2) | 5,363 | (100) |
| ≥2 visits with high BP | 25,593 | (94.6) | 24,140 | (100) | 4,035 | (74.6) | 5,226 | (97.5) |
| Median time between first and last visits with high BP (interquartile range, in weeks) | 31.4 (28.3,34.0) | 31.3 (28.1,34.0) | 31.9 (29.1,34.4) | 30.9 (27.6, 33.7) | ||||
| ≥1 visit with severe high BP | 11,226 | (41.5) | 10,774 | (44.6) | 1,981 | (36.6) | 3,322 | (61.9) |
| From 20 weeks gestation to delivery | ||||||||
| ≥1 visit with high BP | 20,889 | (77.2) | 19,922 | (82.5) | 3,265 | (60.4) | 4,705 | (87.7) |
| ≥1 visit with severe high BP | 5,639 | (20.8) | 5,588 | (23.1) | 9,24 | (17.1) | 1,989 | (37.1) |
Women meeting multiple criteria of the hypertension case definition were included in each group.
High BP criterion: 2 or more BP ≥ 140/90 within 30 days from the start of pregnancy through 35 weeks 6 days; Treated chronic Hypertension criterion: 1 antihypertensive medication fill within 120 days prior to pregnancy and 1 hypertension diagnosis code from 1 year prior to pregnancy through 20 weeks gestation; Rapid Treatment criterion: 1 high BP (≥ 140/90) from the start of pregnancy through 35 weeks 6 days accompanied by 1 diagnosis code and 1 antihypertensive medication fill all within 7 days.
This means the earliest time in pregnancy a diagnosis was recorded, which may not be the first time a woman’s hypertension was recognized in her lifetime.
All pregnancies that met the Treated chronic hypertension criterion had a diagnosis between 1 year prior to pregnancy through 20 weeks. When restricted to time during pregnancy, some (n=269) did not have a diagnosis code, and some had a first code after 20 weeks.
Defined as a hypertension diagnosis in an inpatient setting from three days before delivery through delivery.
High blood pressure (BP) defined as BP ≥ 140/90 mm Hg and severe high BP defined as BP ≥ 160/110 mm Hg. Excluding BP measured on the delivery day.