ABS 013: Socioeconomic factors as predictors of patient follow-up among patients with a hypertensive disorders of pregnancy diagnosis at a safety net hospital

Paige Matarazzo ¹, Michael Xie ², Mark Staroselsky, DO ³, Lorinda Bauer, RN, MBA ³, Ofek Hai, DO ³, Amgad N. Makaryus, MD ², Roman Zeltser, MD ²

¹ The University of Notre Dame
² Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
³ Nassau University Medical Center

Van Wickle (2025) Volume 1, ABS 005

Introduction: Hypertensive disorders of pregnancy (HDP) are associated with adverse effects on mothers and their infants. Previous work exploring socioeconomic factors, such as race and insurance status, lacks data on long-term effects of HDPs. We assessed associations between these factors and type of HDP as predictors of patient follow-up one year after delivery.
This is a retrospective consecutive chart review of pregnant patients seen in the outpatient setting at our safety net hospital. Patient age, body mass index (BMI), race/ethnicity, HDP type, and insurance status were assessed. Logistic regression analyses were conducted to evaluate predictors of patient follow-up one-year post-diagnosis.

Among 387 patients, 10% were non-Hispanic White, 32% Black, 5% American Indian, 5% Asian, 47% Hispanic White, and 1% other race. 87 patients followed up in the outpatient setting one year later. A multiple binary logistic regression model determined that pre-existing HTN (95% CI: 1.034-3.147, p = 0.038) was a significant predictor of follow-up one year after being diagnosed with an HDP. 25 of the 87 patients who followed up 1 year later had an uncontrolled BP reading.

Pre-existing hypertension was the strongest predictor of patient follow-up one year after HDP diagnosis, likely reflecting increased awareness of the importance of medical care. Neither racial or ethnic background nor insurance status affected adherence, which is reassuring given concerns about disparities among minority and uninsured populations. However, over 75% of patients did not follow up, emphasizing the need for improved education, retention, and outreach to ensure HDPs and hypertension are properly managed. Strengthening follow-up efforts provides greater opportunities for education, early intervention, and targeted treatment, helping to prevent adverse events in at-risk patients and improve long-term outcomes overall.

Methods: This is a retrospective consecutive chart review of pregnant patients seen in the outpatient setting at our safety net hospital. Patient age, body mass index (BMI), race/ethnicity, HDP type, and insurance status were assessed. Logistic regression analyses were conducted to evaluate predictors of patient follow-up one-year post-diagnosis.

Results: Among 387 patients, 10% were non-Hispanic White, 32% Black, 5% American Indian, 5% Asian, 47% Hispanic White, and 1% other race. 87 patients followed up in the outpatient setting one year later. A multiple binary logistic regression model determined that pre-existing HTN (95% CI: 1.034-3.147, p = 0.038) was a significant predictor of follow-up one year after being diagnosed with an HDP. 25 of the 87 patients who followed up 1 year later had an uncontrolled BP reading.

Discussion: Pre-existing hypertension was the strongest predictor of patient follow-up one year after HDP diagnosis, likely reflecting increased awareness of the importance of medical care. Neither racial or ethnic background nor insurance status affected adherence, which is reassuring given concerns about disparities among minority and uninsured populations. However, over 75% of patients did not follow up, emphasizing the need for improved education, retention, and outreach to ensure HDPs and hypertension are properly managed. Strengthening follow-up efforts provides greater opportunities for education, early intervention, and targeted treatment, helping to prevent adverse events in at-risk patients and improve long-term outcomes overall.