ACOG 2026: New Study Shows Preventive Care Use Low After Hypertensive Disorders of Pregnancy

Preventive care utilization in the postpartum year was low among insured individuals with hypertensive disorders of pregnancy (HDP), with only 35.3% having a preventive visit within 12 months after birth, according to findings presented at the American College of Obstetricians and Gynecologists (ACOG) 2026 Annual Clinical & Scientific Meeting and simultaneously published in the journal Obstetrics & Gynecology.¹

The study, led by Kimberley H. Geissler of UMass Chan Medical School–Baystate, was conducted to examine whether type of HDP was associated with receipt of preventive care during the year after delivery. Investigators emphasized that the postpartum transition to primary care is critical for individuals with HDP, including preeclampsia and gestational hypertension, because of their substantially increased long-term risk for cardiovascular disease.

Using the Massachusetts All Payer Claims Database, researchers analyzed preventive care use among insured individuals with HDP in the postpartum year. The analysis included 52 962 births and evaluated HDP type as the key independent variable. Categories included gestational hypertension, mild preeclampsia, severe preeclampsia/eclampsia, chronic hypertension, and preeclampsia superimposed on chronic hypertension.

Chronic hypertension was the most common HDP type, accounting for 47.1% of births in the sample. Gestational hypertension accounted for 23.9%, and mild preeclampsia accounted for 12.9%.

After adjustment for age, comorbidities, and insurance type, chronic hypertension was associated with a 2.15 percentage point increase in the probability of having a preventive visit compared with gestational hypertension (95% CI, 1.13-3.16 percentage points). Mild preeclampsia also was associated with a higher probability of preventive visit use compared with gestational hypertension, with an adjusted increase of 1.46 percentage points (95% CI, 0.03-2.89 percentage points).

Although differences by HDP type were small, the findings suggested lower preventive care utilization among individuals with gestational hypertension. Preventive care use was highest among those with chronic hypertension, including those with preeclampsia superimposed on chronic hypertension, but investigators noted that nearly two-thirds of individuals in this group still did not have a preventive visit during the postpartum year.

For primary care physicians, the findings reinforce the importance of identifying patients with any history of HDP and supporting timely postpartum linkage to longitudinal preventive care. Given the established association between HDP and later cardiovascular risk, the postpartum year may represent an important window for blood pressure follow-up, cardiovascular risk assessment, counseling, and care coordination between obstetric and primary care teams.

“These results suggest a need for policies and practices to better facilitate postpartum transition to primary care for individuals with HDP,” Geissler and colleagues concluded.

Reference: Geissler KH, Pearlman J, Shaw S, et al. Hypertensive Disorders of Pregnancy Type and Preventive Care Utilization in the Postpartum Year. Obstetrics & Gynecology. 2026;147:40S-41S. doi:10.1097/AOG.0000000000006267.28