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Epidemiology

Poster Session 2

(425) Effect of the COVID-19 pandemic on population-level mean arterial pressure during pregnancy and postpartum

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: We aimed to assess if population-level mean arterial pressures (MAP) in pregnancy and postpartum changed as a result of the COVID-19 pandemic and if any of these observed changes persisted.

Study Design: This was a retrospective cohort study of pregnancies within a single healthcare system. Using EMR data, patients were assigned to one of four COVID-19 epochs (pre-, acute, and chronic years 1 and 2). Patients were assigned to acute COVID if their estimated due date was before 1/1/2021 and their gestational age was < 20 weeks by 3/10/2020. Pre-COVID and chronic 1 and 2 comprised matched months for the two years prior to, and post, acute COVID. MAP (mm Hg) was calculated for every blood pressure recorded for each patient. The mean MAP (µMAP) was computed for 7 discrete pregnancy periods (1st,  2nd, 3rd trimesters, admission for delivery-delivery [delivery], delivery-discharge [post-delivery], discharge-6 weeks postpartum, and 6 weeks-6 months postpartum). One-way ANOVA with post-hoc Tukey’s honest significance test was employed to compare the µMAP across COVID epochs for each pregnancy period.

Results: A total of 22,998 pregnancies occurred during the COVID epochs with the following distribution: pre-COVID n=9,174; acute COVID n=4,380; chronic 1 n=4,690; chronic 2 n=4,754. Significant elevations in µMAP were observed for the 1st, 2nd, and 3rd trimesters when comparing acute and chronic 1 and 2 to pre-COVID (p< 0.05; Figure). During delivery, no differences in µMAP across epochs were observed. However, we observed significant elevations post-delivery in µMAP for chronic 1 and 2 compared to pre-COVID. µMAPs were significantly higher in both postpartum periods when comparing chronic 2 to pre-COVID.

Conclusion: In general, µMAPs increased during acute COVID and remained elevated in the two chronic COVID epochs across pregnancy and up to 6 months postpartum. These results suggest that the COVID-19 pandemic was associated with population blood pressure elevations in pregnancy and that, at least to date, these changes have not remitted and appear to be durable.