(1139) Hypertensive disorders and postpartum follow up: care in and outside the hospital

Objective: We sought to evaluate the role of social determinants of health (SDH) in postpartum care delivery and utilization among patients with hypertensive disorders of pregnancy (HDP) by examining rates of 6 week follow up and unscheduled healthcare utilization.

Study Design: This was a retrospective cohort study of patients who delivered at a single hospital between 12/2020 and 2/2023 including those diagnosed with preeclampsia with/without severe features during pregnancy or in the postpartum period. Exclusion criteria: < 18 years of age, delivered < 20 weeks GA, or delivered with community practices. SDH included age, self-identified race and ethnicity, marital status, number of living children, health insurance, and area deprivation index (a mapping tool from 1 [most advantaged] to 10 [least advantaged] obtained from census data displaying relative socioeconomic conditions of regions). Statistical analysis included cross-tabulation, chi-square tests, independent samples t-tests, bivariate analyses, and multivariable logistic regression analyses. Statistical significance was determined using a threshold of p < 0.05.

Results: 257 patients were included (Table 1). Being single, having prior living children, and belonging to a racial or ethnic group other than White non-Hispanic was significantly associated with poor attendance at the six-week postpartum visit (Table 2). Unscheduled hospital admissions were also significantly associated with being black, higher ADI scores, and having living children (p< 0.05) (Table 3).

Conclusion: SDH were significantly associated with poor postpartum follow up and higher rates of unscheduled health care utilization.