Abstract Body (Do not enter title and authors here): Background: Hypertensive disorders of pregnancy (HDP) serve as the second leading cause of maternal mortality globally and represent a threat to pregnancies across our nation. Blood pressure goals and practice patterns continue to vary broadly between and within institutions. An updated analysis of the management and outcomes of HDP is necessary. The aim is to evaluate maternal and neonatal outcomes for patients admitted due to HDP at our institution.

Methods: Patients (≥18 years of age) 23⁺⁰ to 34⁺⁶ weeks’ gestation who were hospitalized at the University of Chicago with a HDP associated condition between January 1^st, 2022, and January 31^st, 2024 were included in this cohort study. Demographics, maternal/neonatal events, and the correlation between interventions received during pregnancy and HDP outcomes were assessed.

Results: Our study included 140 patients with HDP, of which 46 (32.9%) had preeclampsia (preE) with severe features (SF), 13 (9.3%) had preE without SF, 10 (7.1%) had gestational HTN, and 26 (18.6%) had cHTN. Our cohort was predominantly African American (n = 86; 61.4%) with median age 31 years (IQR 26, 35). Among patients with a preterm delivery (80.4%), the most common indication for delivery was persistent severe hypertension (81.1%). Modest correlations were observed between birthweight percentile and both systolic BP (Spearman r = -0.189 [95% CI: -0.368, 0.004]; p = 0.06) and diastolic BP (r = -0.197, [95% CI: -0.373, -0.002]; p = 0.047), with BP decreasing as the percentile increased. Figure 1 outlines the latency between admission date and delivery. Patients on an antihypertensive medication at the time of postpartum discharge were less likely to be readmitted within six weeks (9.0% vs 22.0%; p = 0.03) due to BP control as compared to patients who were not on medication.

Conclusion: This study demonstrates that severe HTN feature of HDP is most associated with neonatal adverse outcomes and maternal postpartum readmissions. Patients with HDP can benefit from an improved stratification tool during antepartum and at discharge to identify patients at higher risk of neonatal/maternal adverse outcomes.