Evidence map›Paper›PMID 26416810›Full record

Observational studyCirculation2015

Epidemiology and Mechanisms of De Novo and Persistent Hypertension in the Postpartum Period.

Arvind Goel, Manish R Maski, Surichhya Bajracharya, Julia B Wenger, Dongsheng Zhang, Saira Salahuddin, Sajid S Shahul, Ravi Thadhani, Ellen W Seely, S Ananth Karumanchi and 1 more

Registry-linked trialOpen access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Circulation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03728790 (A Remote Postpartum), which is not on this map. Cited by 87 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 4 pooled it
7.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03728790 nacompletednot on this mapstarted 2018, after this paper: background citation

A Remote Postpartum (PP) Blood Pressure Surveillance and Reminder System for Hypertensive Disorders of Pregnancy: A Randomized Clinical Trial

TypeinterventionalSponsorColumbia UniversityRan2018 to 2020Enrolled213ConditionsHypertensive Disorder of PregnancyArmsRemote Patient Monitoring
3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 4 syntheses or guidelines pooled it, 190 citations in OpenAlex.

  1. Pooled it
  2. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
  3. Guideline
  4. Pooled it
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
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  12. Article
  13. Review
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  15. Article
  16. Article
  17. Review
  18. Article
  19. Novel biomarkers for preeclampsia: Promises and pitfalls.Current opinion in obstetrics & gynecology · 2025
    Review
  20. Article

27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Arvind GoelFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Manish R MaskiFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Surichhya BajracharyaFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Julia B WengerFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Dongsheng ZhangFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Saira SalahuddinFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Sajid S ShahulFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Ravi ThadhaniFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
Ellen W SeelyFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.).
S Ananth KarumanchiFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.). sananth@bidmc.harvard.edu srana2@bsd.uchicago.edu.
Sarosh RanaFrom Division of Nephrology, Department of Medicine (A.G., M.R.M., D.Z., S.A.K.), Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (S.B., S.S., S.A.K., S.R.), and Division of Critical Care, Department of Anesthesiology (S.S.S.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.B.W., R.T.); Division of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.W.S.); Howard Hughes Medical Institute, Boston, MA (S.A.K.); and Section of Maternal-Fetal Medicine/Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL (S.R.). sananth@bidmc.harvard.edu srana2@bsd.uchicago.edu.
Brigham and Women's Hospital · USHoward Hughes Medical Institute · USHarvard University · US

Funding

RESEARCH TRAINING IN NEPHROLOGYT32DK007199 · NIDDK · BETH ISRAEL DEACONESS MEDICAL CENTER · PI POLLAK, MARTIN R. · 1986 to 2022
$6.0M
Angiogenic factors, abnormal placentation and adverse pregnancy outcomesK08HD068398 · NICHD · UNIVERSITY OF CHICAGO · PI RANA, SAROSH · 2012 to 2014
$390k
NICHD NIH HHS K08 HD068398NIDDK NIH HHS T32 DK007199
6 · The paper itself

Abstract

backgroundThe pathophysiology of hypertension in the immediate postpartum period is unclear. METHODS AND

resultsWe studied 988 consecutive women admitted to a tertiary medical center for cesarean section of a singleton pregnancy. The angiogenic factors soluble fms-like tyrosine kinase 1 and placental growth factor, both biomarkers associated with preeclampsia, were measured on antepartum blood samples. We then performed multivariable analyses to determine factors associated with the risk of developing postpartum hypertension. Of the 988 women, 184 women (18.6%) developed postpartum hypertension. Of the 184 women, 77 developed de novo hypertension in the postpartum period, and the remainder had a hypertensive disorder of pregnancy in the antepartum period. A higher body mass index and history of diabetes mellitus were associated with the development of postpartum hypertension. The antepartum ratio of soluble fms-like tyrosine kinase 1 to placental growth factor positively correlated with blood pressures in the postpartum period (highest postpartum systolic blood pressure [r=0.29, P<0.001] and diastolic blood pressure [r=0.28, P<0.001]). Moreover, the highest tertile of the antepartum ratio of soluble fms-like tyrosine kinase 1 to placental growth factor was independently associated with postpartum hypertension (de novo hypertensive group: odds ratio, 2.25; 95% confidence interval, 1.19-4.25; P=0.01; in the persistent hypertensive group: odds ratio, 2.61; 95% confidence interval, 1.12-6.05; P=0.02) in multivariable analysis. Women developing postpartum hypertension had longer hospitalizations than those who remained normotensive (6.5±3.5 versus 5.7±3.4 days; P<0.001).

conclusionsHypertension in the postpartum period is relatively common and is associated with prolonged hospitalization. Women with postpartum hypertension have clinical risk factors and an antepartum plasma angiogenic profile similar to those found in women with preeclampsia. These data suggest that women with postpartum hypertension may represent a group of women with subclinical or unresolved preeclampsia.

Indexed as

AdultCesarean SectionDiabetes, GestationalFemaleHumansHypertensionHypertension, Pregnancy-InducedLength of StayObesityPlacenta Growth FactorPostoperative ComplicationsPre-EclampsiaPregnancyPregnancy ComplicationsPregnancy in DiabeticsPregnancy ProteinsFLT1 protein, humanPGF protein, humanPlacenta Growth FactorPregnancy ProteinsVascular Endothelial Growth Factor Receptor-1hypertensionpostpartumpre-eclampsiapregnancyreceptors, vascular endothelial growth factor

Identifiers

PMID26416810
PMCPMC4816491
OpenAlexW2118020130

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.