{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:00:27Z","timestamp":1793059227484,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1TR002555"],"award-info":[{"award-number":["TL1TR002555"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006510","name":"Duke University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006510","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["HX\u201009\u2010335"],"award-info":[{"award-number":["HX\u201009\u2010335"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the prevalence of maternal chronic hypertension (MCH), assess how frequently blood pressure is controlled before pregnancy among those with MCH, and explore management practices for antihypertensive medications (AHM) during the pre\u2010pregnancy and pregnancy periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources, Study Setting, and Study Design<\/jats:title><jats:p>We conducted a descriptive observational study using data abstracted from the Veterans Health Administration (VA) inclusive of approximately 11 million Veterans utilizing the VA in fiscal years 2010\u20132019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection\/Extraction Methods<\/jats:title><jats:p>Veterans aged 18\u201350 were included if they had a diagnosis of chronic hypertension before a documented pregnancy in the VA EMR. We identified chronic hypertension and pregnancy with diagnosis codes and defined uncontrolled blood pressure as \u2265140\/90\u2009mm Hg on at least one measurement in the year before pregnancy. Sensitivity models were conducted for individuals with at least two blood pressure measurements in the year prior to pregnancy. Multivariable logistic regression explored the association of covariates with recommended and non\u2010recommended AHMs received 0\u20136\u2009months before pregnancy and during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>In total, 8% (3767\/46,178) of Veterans with a documented pregnancy in VA data had MCH. Among 2750 with MCH meeting inclusion criteria, 60% (<jats:italic>n<\/jats:italic>\u2009=\u20091626) had uncontrolled blood pressure on at least one BP reading and 31% (<jats:italic>n<\/jats:italic>\u2009=\u2009846) had uncontrolled blood pressure on at least two BP readings in the year before pregnancy. For medications, 16% (<jats:italic>n<\/jats:italic>\u2009=\u2009437) received a non\u2010recommended AHM during pregnancy. Chronic kidney disease (OR\u2009=\u20093.2; 1.6\u20136.4) and diabetes (OR\u2009=\u20092.3; 1.7\u20133.0) were most strongly associated with use of a non\u2010recommended AHM during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Interventions are needed to decrease the prevalence of MCH, improve preconception blood pressure control, and ensure optimal pharmacologic antihypertensive management among Veterans of childbearing potential.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14277","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T05:37:50Z","timestamp":1705556270000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Maternal chronic hypertension in women veterans"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9930-0852","authenticated-orcid":false,"given":"Ceshae C.","family":"Harding","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4419-5869","authenticated-orcid":false,"given":"Karen M.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine Duke University  Durham North Carolina USA"},{"name":"Durham VA Health Care System  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine Yale New Haven Health System  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarahn M.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nia S.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel A.","family":"Copeland","sequence":"additional","affiliation":[{"name":"VA Central Western Massachusetts Healthcare System  Leeds Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.601"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/grf.0000000000000255"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.235"},{"key":"e_1_2_7_5_1","volume-title":"Sourcebook: Women Veterans in the Veterans Health Administration. Volume 4: Longitudinal Trends in Sociodemographics, Utilization, Health Profile, and Geographic Distribution","author":"Frayne SM","year":"2018"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.026"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181e57946"},{"key":"e_1_2_7_8_1","volume-title":"VA\/DoD Clinical Practice Guideline for the Management of Pregnancy","year":"2018"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010015\u20100064\u20107"},{"key":"e_1_2_7_10_1","volume-title":"Maternity Health Care and Coordination","year":"2020"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000437385.88715.4a"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.3808"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(92)90133\u20108"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1243"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000003020"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.301.6752.587"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.118.11660"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000003013"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.03.021"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.12968"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000000376"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000003267"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455065211009751"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20107061(94)00196\u2010i"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.04.007"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010017\u20104049\u20103"},{"key":"e_1_2_7_28_1","unstructured":"VA health care copay rates.https:\/\/www.va.gov\/health-care\/copay-rates\/. 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