Association between urine protein‐to‐creatinine ratio and postpartum resistant hypertension in patients with severe preeclampsia: A retrospective cohort study

OBJECTIVE: Our objective was to investigate the association between elevated urine protein-to-creatinine ratio (UPCR) and resistant hypertension during postpartum hospitalization in patients with severe preeclampsia at a tertiary care center in Colombia. METHODS: This retrospective cohort study was conducted in Medellín, Colombia. Patients aged >18 years diagnosed with severe preeclampsia who underwent UPCR assessment were included. Associations between elevated UPCR (≥0.3) and resistant hypertension during postpartum hospitalization were evaluated using robust Poisson regression models. RESULTS: A total of 261 patients were included in the study. Bivariate analysis showed that resistant hypertension in the postpartum period was more frequent in the UPCR ≥0.3 group than in the UPCR <0.3 group (43.2% vs. 12.7%; risk ratio 3.69; 95% confidence interval 1.92-7.07). After adjustment for maternal age, body mass index, and gestational age at diagnosis, elevated UPCR remained independently associated with resistant hypertension (adjusted risk ratio 4.87; 95% confidence interval 1.86-12.76). Earlier gestational age at diagnosis was also independently associated with resistant hypertension. CONCLUSION: The UPCR is independently associated with the development of resistant hypertension during postpartum hospitalization in patients with severe preeclampsia.