BACKGROUND AND PURPOSE:

• Do et al. (Obstetrics & Gynecology, 2022) assessed whether readmission for hypertension by 6 weeks postpartum differed between patients discharged on nifedipine vs labetalol

METHODS:

• Cohort study
  • Data derived from large, national adjudicated claims database
• Population
  • Delivery admissions from 2006 to 2017
• Exposure
  • Prescribed at Discharge
    • Nifedipine
    • Labetalol
    • Combined nifedipine and labetalol
• Study design
  • 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
• Primary outcomes
  • Hospital readmission for hypertension

RESULTS:

• 1,582,335 patients
  • Discharged postpartum with nifedipine: 0.57%
  • Discharged postpartum with labetalol: 0.89%
  • Discharged with both: 0.09%
• Postpartum readmissions for hypertension were more frequent for patients discharged on labetalol compared with nifedipine
  • Labetalol: 4.5%
  • Nifedipine: 2.1%
  • Adjusted odds ratio (aOR) 1.63 (95% CI, 1.43 to 1.85)
• Readmissions were more frequent with labetalol for both
  • Mild hypertensive disorders of pregnancy
    • Labetalol: 4.5%
    • Nifedipine: 2.7%
    • aOR 1.57 (95% CI, 1.29 to 1.93)
  • Severe hypertensive disorders of pregnancy
    • Labetalol: 5.7%
    • Nifedipine: 3.2%
    • aOR 1.63 (95% CI, 1.43 to 1.85)
• Odds for readmissions for hypertension were lower after confounder adjustment
  • Combined therapy: 3.1%
  • Nifedipine: 2.1%
  • aOR 0.80 (95% CI, 0.64 to 0.99)

CONCLUSION:

• When patients were discharged with labetalol, there was an increased risk for readmission for hypertension vs nifedipine
• The authors state

In this large cohort study, postpartum patients discharged on labetalol were more likely to be readmitted for hypertension, regardless of the severity of their hypertensive disorder of pregnancy, than those discharged on nifedipine

Learn More – Primary Sources:

Postpartum Readmission for Hypertension After Discharge on Labetalol or Nifedipine

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