ObjectiveWe assessed the association between postpartum preeclampsia and the risk of adverse maternal and neonatal outcomes. Evidence suggests that postpartum preeclampsia is initiated antenatally, but the impact on birth outcomes is unclear.DesignRetrospective cohort study.SettingAll deliveries in hospitals of Quebec, Canada.Population1 317 181 pregnancies between 2006 and 2022.MethodsWe identified patients who developed preeclampsia in the postpartum period. Using log‐binomial regression models, we estimated adjusted risk ratios (RR) and 95% confidence intervals (CI) for the association of postpartum or antepartum preeclampsia with adverse pregnancy outcomes relative to no preeclampsia.Main Outcome MeasuresPreterm birth, placental abruption, severe maternal morbidity and recurrent preeclampsia.ResultsPostpartum preeclampsia was less frequent than antepartum preeclampsia (n = 4123 [0.3%] vs. 51 269 [3.9%]). Postpartum preeclampsia was associated with preterm birth (RR 1.45, 95% CI 1.34–1.57), placental abruption (RR 1.36, 95% CI 1.16–1.59) and severe maternal morbidity (RR 6.48, 95% CI 5.87–7.16) compared with no preeclampsia. Antepartum preeclampsia was also associated with these outcomes. Moreover, patients with postpartum preeclampsia in a first pregnancy were at risk of adverse outcomes in a subsequent pregnancy, particularly recurrent preeclampsia (RR 7.77, 95% CI 6.54–9.23).ConclusionsPostpartum preeclampsia is associated with adverse outcomes at delivery, despite being detected only postnatally. Our findings suggest that patients with adverse birth outcomes may benefit from blood pressure measurements up to 6 weeks following delivery.

中文翻译：

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产后子痫前期的结果：一项对 130 万例妊娠的回顾性队列研究


目的我们评估了产后子痫前期与孕产妇和新生儿不良结局风险之间的相关性。有证据表明，产后子痫前期始于产前，但对出生结局的影响尚不清楚。设计回顾性队列研究。地点加拿大魁北克省医院的所有分娩.人口1 317 181 年间 2006 年至 2022 年间怀孕.方法我们确定了在产后发生子痫前期的患者。使用对数二项式回归模型，我们估计了产后或产前子痫前期与无子痫前期相关妊娠不良结局的调整后风险比 （RR） 和 95% 置信区间 （CI）。主要结局指标早产、胎盘早剥、严重孕产妇发病率和复发性子痫前期。结果产后子痫前期比产前子痫前期少 （n = 4123 [0.3%] vs. 51 269 [3.9%]）。与无子痫前期相比，产后子痫前期与早产 （RR 1.45， 95% CI 1.34–1.57）、胎盘早剥 （RR 1.36， 95% CI 1.16–1.59） 和严重孕产妇发病率 （RR 6.48， 95% CI 5.87–7.16） 相关。产前子痫前期也与这些结局相关。此外，第一次妊娠的产后子痫前期患者在随后的妊娠中有不良结局的风险，特别是复发性子痫前期（RR 7.77,95% CI 6.54–9.23）。结论产后子痫前期与分娩时的不良结局相关，尽管仅在出生后检测到。我们的研究结果表明，出生结局不良的患者可能会受益于分娩后 6 周内的血压测量。