Labor therapeutics and BMI as risk factors for postpartum preeclampsia: A case-control study

Objectives: This study aims at identifying associations between therapeutics used during labor and the occurrence of postpartum preeclampsia (PPPE), a poorly understood entity. Study design and main outcome measures: This is a case-control study of women who received an ICD-9 code for PPPE (cases) during the years 2009-2011, compared to women with a normotensive term pregnancy, delivery and postpartum period until discharge (controls), matched on age (+/- 1 year) and delivery date (+/- 3 months). Cases were defined as women having a normotensive term pregnancy, delivery and initial postpartum period (48 h post-delivery) but developing hypertension between 48 h and 6 weeks postpartum. Single variable and multiple variable models were used to determine significant risk factors. Results: Forty-three women with PPPE were compared to 86 controls. Use of vasopressors and oxytocin did not differ between cases and controls, but rate of fluids administered during labor (OR = 1.68 per 100 cc/h; 95% CI: 1.09-2.59, p = 0.02) and an elevated pre-pregnancy/first trimester BMI (OR = 1.18 per kg/m(2), 95% CI: 1.07-1.3, p = 0.001) were identified as significant risk factors in multivariate analysis. Conclusions: We identified two potentially modifiable risk factors for PPPE; further studies are needed to better define the role of these two variables in the development of PPPE. (C) 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.