Home blood pressure monitoring and pregnancy outcomes in gestational hypertension

  • Kalafat E & al.
  • Pregnancy Hypertens
  • 15 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In pregnant with gestational hypertension (GH), home blood pressure monitoring (HBPM) was significantly associated with reduction in antenatal visits compared with office (traditional) BP measurement.
  • Adverse maternal and perinatal outcomes were comparable between both groups.

Why this matters

  • Findings expand the maternal, foetal and neonatal safety data of the use of HBPM during pregnancy.
  • Large trials are needed to ascertain the safety of rare adverse pregnancy outcomes.

Study design

  • Cohort study of 143 pregnant women with GH, who followed an individualised schedule of hospital visits and BP measurements based on the HBPM (n=80) or standard care (control group; n=63) as per the National Institute of Health and Care Excellence guideline (NICE) guideline.
  • Main outcomes: difference in adverse foetal, neonatal and maternal outcomes, and number of antenatal hospital visits between HBPM and standard care.
  • Funding: The Health Foundation.

Key results

  • No significant difference observed between HBPM and control groups in:
    • maternal high-dependency unit admission (P=.999),
    • birth weight centile (P=.803),
    • foetal growth restriction (P=.999),
    • neonatal intensive care unit admissions (P=.507),
    • composite neonatal (P=.654), maternal or foetal adverse outcomes (P=.999 for both) and
    • total number of outpatient (P=.357) and triage visits (P=.237).
  • After adjustment for the duration of monitoring per weeks:
    • The number of day assessment unit visits was significantly lower in the HBPM vs control group (median, 1.0 vs 1.5; P<.001>
    • HBPM vs control group had a significant reduction in the number of total antenatal visits (median, 1.4 vs 1.8; P=.020).

Limitations

  • Risk of bias.
  • Small sample size.