Incidence of postpartum hypertension within 2 years of a pregnancy complicated by pre-eclampsia: a systematic review and meta-analysis

Giorgione, V
Ridder, A.
Kalafat, E.
Khalil, A.
Thilaganathan, B.
Background Women with a history of hypertensive disorders of pregnancy (HDP) are at increased long-term risk of cardiovascular disease. However, there has been increasing evidence on the same risks in the months following birth. Objectives This review aims to estimate the incidence of hypertension in the first 2 years after HDP. Search strategy MEDLINE, Embase and Cochrane databases were systematically searched in October 2019. Selection criteria Observational studies comparing hypertension rate following HDP and normotensive pregnancies up to 2 years. Data collection and analysis A meta-analysis to calculate the odds ratio (OR) with a 95% confidence interval (CI) and a sub-group analysis excluding women with chronic hypertension were performed. Main results Hypertension was diagnosed within the first 2 years following pregnancy in 468/1646 (28.4%) and 584/6395 (9.1%) of the HDP and control groups, respectively (OR 6.28; 95% CI 4.18-9.43;I-2 = 56%). The risk of hypertension in HDP group was significantly higher in the first 6 months following delivery (OR 18.33; 95% CI 1.35-249.48;I-2 = 84%) than at 6-12 months (OR 4.36; 95% CI 2.81-6.76;I-2 = 56%) or between 1-2 years postpartum (OR 7.24; 95% CI 4.44-11.80;I-2 = 9%). A sub-group analysis demonstrated a similar increase in the risk of developing postpartum hypertension after HDP (OR 5.75; 95% CI 3.92-8.44;I-2 = 49%) and pre-eclampsia (OR 6.83; 95% CI 4.25-10.96;I-2 = 53%). Conclusions The augmented risk of hypertension after HDP is highest in the early postpartum period, suggesting that diagnosis and targeted interventions to improve maternal cardiovascular health may need to be commenced in the immediate postpartum period. Tweetable abstract The risk of hypertension within 2 years of birth is six-fold higher in women who experienced pre-eclampsia.


Home blood pressure monitoring in the antenatal and postpartum period: A systematic review meta-analysis
Kalafat, Erkan; Benlioglu, Can; Thilaganathan, Basky; Khalil, Asma (Elsevier BV, 2020-01-01)
Recent evidence suggests that home blood pressure monitoring (HBPM) is an effective way of managing women with hypertensive disorders of pregnancy (HDP) without increasing adverse outcomes. The aim of this systematic review and meta-analysis was to investigate the safety and efficacy of HBPM during pregnancy.
Efficacy of citalopram on climacteric symptoms
Kalay, Aysegul E.; Demir, Berfu; Haberal, Ali; Kalay, Mustafa; Kandemir, Omer (Ovid Technologies (Wolters Kluwer Health), 2007-03-01)
Objective: The aim of this study was to evaluate the efficacy of citalopram for climacteric symptoms and to assess the combined effect of citalopram and hormone therapy (HT) on climacteric symptoms in women inadequately responsive to HT alone.
Metabolic syndrome and its components in premenopausal and postmenopausal women: a comprehensive systematic review and meta-analysis on observational studies
Hallajzadeh, Jamal; Khoramdad, Maliheh; Izadi, Neda; Karamzad, Nahid; Almasi-Hashiani, Amir; Ayubi, Erfan; Qorbani, Mostafa; Pakzad, Reza; Hasanzadeh, Amir; Sullman, Mark J. M.; Safiri, Saeid (Ovid Technologies (Wolters Kluwer Health), 2018-10-01)
Objectives: To perform a meta-analysis on the global prevalence of metabolic syndrome (MetS) in postmenopausal women. The meta-analysis also sought to measure the relationship menopause status has with MetS and its components.
The role of aspirin in prevention of preeclampsia in twin pregnancies: does the dose matter?
Kalafat, Erkan; Shirazi, Amani; Thilaganathan, Basky; Khalil, Asma (Elsevier BV, 2020-09-01)
Objective The use of aspirin in twin pregnancies for the prevention of preeclampsia is a controversial topic, and evidence on the required dose of aspirin is scarce. We aimed to assess the efficacy of 75 mg/day vs 150 mg/day aspirin for the prevention of preeclampsia in twin pregnancies. Study Design This is a retrospective cohort study of twin pregnancies managed at St George’s University Hospital between 2012 and 2019. The National Institute for Health and Care Excellence guideline published in 2010 has...
Genetic aspects of human male infertility: the frequency of chromosomal abnormalities and Y chromosome microdeletions in severe male factor infertility
Vicdan, A; Vicdan, K; Gunalp, S; Kence, Aykut; Akarsu, C; Isik, AZ; Sozen, E (Elsevier BV, 2004-11-10)
Objective: The main purpose of this, study is to detect the frequency and type of both chromosomal abnormalities and Y chromosome microdeletions in patients with severe male factor infertility and fertile control subjects. The association between the genetic abnormality and clinical parameters was also evaluated. Methods: This study was carried out in 208 infertile and 20 fertile men. Results of 208 patients, 1 19 had non-obstructive azoospermia and 89 had severe oligoasthenoteratozoospermia (OAT). Seventee...
Citation Formats
V. Giorgione, A. Ridder, E. Kalafat, A. Khalil, and B. Thilaganathan, “Incidence of postpartum hypertension within 2 years of a pregnancy complicated by pre-eclampsia: a systematic review and meta-analysis,” BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, pp. 0–0, 2020, Accessed: 00, 2020. [Online]. Available: