Nakimuli Annettee, Okello Emmy, Kesiiga Annette, Adroma Moses, Akello Jackline, Nabweyambo Sheila, Sekikubo Musa, Namagembe Imelda, Kayesubula Robert, Galiwango Ronald, Jasper Brittany, Moffett Ashley, Aiken Catherine E, Wilkinson Ian B, McEniery Carmel M
Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Uganda Heart Institute, At Mulago, Kampala, Uganda.
BJOG. 2025 Aug;132(9):1319-1328. doi: 10.1111/1471-0528.18192. Epub 2025 Apr 28.
To investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.
Prospective cohort study.
Tertiary referral hospital in urban Uganda.
Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.
Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.
The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.
At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16-1.36, p < 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, p < 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, p < 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (p = 0.35).
In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. Over one-third of women with pre-eclampsia developed hypertension at one year postpartum, emphasising the need for postpartum blood pressure monitoring and early intervention to mitigate long-term cardiovascular risk in this high-risk population.
调查乌干达资源匮乏地区患先兆子痫的非洲黑人女性产后1年高血压和心血管功能障碍的患病率。
前瞻性队列研究。
乌干达城市的三级转诊医院。
2019年至2021年间患先兆子痫的孕妇，并与具有相同孕产妇年龄和孕周的血压正常对照者匹配。
在招募时和产后1年收集社会人口学、临床和实验室数据。计算基线特征和发病率比以评估高血压的危险因素。采用针对匹配研究设计进行调整的多变量条件泊松回归分析结果。
主要结局是产后1年高血压（收缩压≥140mmHg和/或舒张压≥90mmHg）。次要结局包括产后1年的主动脉脉搏波速度、左心室质量指数和左心室射血分数。
产后1年，先兆子痫女性的高血压患病率高于对照组（36.4%（96/264）对4.5%（12/264）；发病率比1.26，95%置信区间1.16 - 1.36，p<0.001）。先兆子痫女性产后主动脉脉搏波速度中位数增加（6.45±0.76m/s对5.67±0.22m/s，p<0.001）。先兆子痫女性按体表面积计算的左心室质量增加（71.7±19.6g对76.5±23.2g，p<0.01）。左心室射血分数不受先兆子痫影响（p = 0.35）。
在这个资源匮乏地区，患先兆子痫的非洲黑人女性产后1年心血管风险标志物增加。超过三分之一的先兆子痫女性产后1年患高血压，强调需要进行产后血压监测和早期干预，以降低这一高危人群的长期心血管风险。
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