# Comprehensive Postpartum Management for Women with Hypertensive Disorders of Pregnancy

> **NIH NIH R21** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $265,928

## Abstract

SUMMARY
Hypertensive disorders of pregnancy (HDP) - chronic hypertension, gestational hypertension, preeclampsia,
HELLP, and eclampsia - account for a substantial portion of severe maternal morbidity and mortality in the U.S.
and occur 2.5 times more frequently among Black compared to non-Black patients. The weeks after birth are
crucial for maternal health, especially considering that half of all pregnancy-related deaths occur postpartum.
The American College of Obstetricians and Gynecologists recently redefined postpartum care to encompass
12 months after birth and stressed the importance of connecting postpartum patients to primary care clinicians
to manage chronic medical conditions. This handoff is critical as 50% of patients with HDP develop chronic
hypertension, and patients with HDP have twice the risk of later cardiovascular-related death. In line with this
recommendation, Tennessee recently expanded Medicaid coverage to 12 months postpartum. Given that most
obstetric clinicians currently do not provide comprehensive primary care, we urgently need models for bridging
gaps in care after pregnancy especially for medically vulnerable patients. While interventions such as
telemedicine and peer navigation demonstrate promise to improve patient engagement in care and reduce
postpartum racial disparities, no randomized trials address system-level initiatives to improve postpartum care
for patients with HDP. We propose to build a comprehensive management program for postpartum patients
with HDP who are at risk of severe maternal morbidity and mortality. Using a community-engaged approach,
we will tailor this program to Black patients who represent a disproportionate share of those affected by
postpartum HDP. This program emphasizes three key components: 1) self-monitoring of blood pressures, 2)
blood pressure management navigation, and 3) facilitated transition to primary care clinicians for hypertension
management. Our multidisciplinary team, including maternal-fetal medicine specialists, certified nurse
midwives, program navigators, and social workers will accomplish our specific aims to: 1) conduct rigorous
patient engagement that identifies barriers and facilitators to postpartum hypertension care especially among
Black patients 2) conduct rigorous clinician engagement that uncovers barriers and facilitators to postpartum
hypertension management, and 3) perform a pilot randomized trial comparing usual postpartum care to our
comprehensive HDP management program. We hypothesize that our intervention will increase patient
engagement with blood pressure monitoring, identify more patients with severe-range blood pressures, and
reduce disparities in outcomes between Black and non-Black patients. Our work directly advances integrated
models of care using community-engaged research among populations who bear a disproportionate burden of
severe maternal morbidity and mortality. The results will produce stakeholder-informed outcomes and key
parameter ...

## Key facts

- **NIH application ID:** 10604847
- **Project number:** 1R21NR020857-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Sarah Scheiderich Osmundson
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $265,928
- **Award type:** 1
- **Project period:** 2022-09-21 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10604847

## Citation

> US National Institutes of Health, RePORTER application 10604847, Comprehensive Postpartum Management for Women with Hypertensive Disorders of Pregnancy (1R21NR020857-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10604847. Licensed CC0.

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