Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 1;140(4):591-598.
doi: 10.1097/AOG.0000000000004918. Epub 2022 Sep 7.

Postpartum Readmission for Hypertension After Discharge on Labetalol or Nifedipine

Samantha C Do  1 , Stephanie A Leonard, Peiyi Kan, Danielle M Panelli, Anna I Girsen, Deirdre J Lyell, Yasser Y El-Sayed, Maurice L Druzin, Tiffany Herrero
Affiliations

Postpartum Readmission for Hypertension After Discharge on Labetalol or Nifedipine

Samantha C Do et al. Obstet Gynecol. .

Abstract

Objective: To assess whether readmission for hypertension by 6 weeks postpartum differed between patients discharged on nifedipine or labetalol.

Methods: This cohort study included patients with delivery admissions from 2006 to 2017 who were discharged from the hospital on nifedipine or labetalol and were included in a large, national adjudicated claims database. We identified patients' discharge medication based on filled outpatient prescriptions. We compared rates of hospital readmission for hypertension between patients discharged postpartum on labetalol alone, nifedipine alone, or combined nifedipine and labetalol. Patients with chronic hypertension without superimposed preeclampsia were excluded. Comparisons based on medication were performed using logistic regression models with adjustment for prespecified confounders. Comparisons were also stratified by hypertensive disorder of pregnancy severity.

Results: Among 1,582,335 patients overall, 14,112 (0.89%) were discharged postpartum on labetalol, 9,001 (0.57%) on nifedipine, and 1,364 (0.09%) on both medications. Postpartum readmissions for hypertension were more frequent for patients discharged on labetalol compared with nifedipine (641 patients vs 185 patients, 4.5% vs 2.1%, adjusted odds ratio [aOR] 1.63, 95% CI 1.43-1.85). Readmissions for hypertension were more frequent for patients discharged on labetalol compared with nifedipine for both mild (4.5% vs 2.7%, aOR 1.57, 95% CI 1.29-1.93) and severe hypertensive disorders of pregnancy (261 patients vs 72 patients, 5.7% vs 3.2%, aOR 1.63, 95% CI 1.43-1.85). Readmissions for hypertension were more frequent on combined nifedipine and labetalol compared with nifedipine (3.1% vs 2.1%), but the odds were lower after confounder adjustment (aOR 0.80, 95% CI 0.64-0.99).

Conclusion: Postpartum discharge on labetalol was associated with increased risk of readmission for hypertension compared with discharge on nifedipine.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure Deirdre J. Lyell disclosed receiving payment from the Society of Maternal-Fetal Medicine, Wolters Kluwer, Bloomlife, Zenflow, and Elsevier. The other authors did not report any potential conflicts of interest.

References

    1. Behrens I, Basit S, Lykke JA, Ranthe MF, Wohlfahrt J, Bundgaard H, et al. Association between hypertensive disorders of pregnancy and later risk of cardiomyopathy. JAMA J Am Med Assoc 2016;315:1026–33. doi: 10.1001/jama.2016.1869 - DOI
    1. Sibai BM. Hypertensive disorders of pregnancy: the United States perspective. Curr Opin Obstet Gynecol 2008;20:102–6. doi: 10.1097/GCO.0b013e3282f73380 - DOI
    1. Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstet Gynecol 2005;105:402–10. doi: 10.1097/01.AOG.0000152351.13671.99 - DOI
    1. Mogos MF, Salemi JL, Spooner KK, McFarlin BL, Salihu HH. Hypertensive disorders of pregnancy and postpartum readmission in the United States: national surveillance of the revolving door. J Hypertens 2018;36:608–18. doi: 10.1097/HJH.0000000000001594 - DOI
    1. Stamilio DM, Beckham AJ, Boggess KA, Jelovsek JE, Venkatesh KK. Risk factors for postpartum readmission for preeclampsia or hypertension before delivery discharge among low-risk women: a case-control study. Am J Obstet Gynecol MFM 2021;3:100317. doi: 10.1016/j.ajogmf.2021.100317 - DOI