Abstract P647: Assessing the Current Practice of Home Blood Pressure Reporting During Pregnancy

Background: Hypertension (HTN) during pregnancy is a leading cause of fetal and maternal morbidity and is increasingly prevalent in the United States. Home blood pressure (HBP) monitoring allows for blood pressure surveillance throughout pregnancy and can prompt pregnant women to seek medical attention if their blood pressure exceeds safe thresholds. Objectives: To assess the current practice of HBP reporting in pregnancy. Methods: We enrolled 38 pregnant women at 24-32 weeks gestation with either a chronic HTN diagnosis or systolic blood pressure of 140-159 and 40 pregnant women without HTN between July 2019 and November 2021. Clinic visits (telehealth and in-person) were retrospectively reviewed. Each visit with recordings of HBP was categorized as: exact HBP readings, ranges of readings, or qualitative assessment (e.g., normal) of HBP readings during pregnancy and postpartum. Two-sample test of proportion was used for comparisons. Results: Of the 38 women with HTN, 27 (71%) had at least one recorded HBP in pregnancy or postpartum, compared to 2 (5%) women without HTN. There was a total of 158 prenatal visits with HBP recorded and 39 readings postpartum. Readings were more likely to be reported as an exact HBP in the postpartum period (49%) vs. prenatal period (23%, p = 0.001, Figure ). In the prenatal period, 47% of the visits recording HBP reported a range of readings. Discussion: In this population of pregnant women with HTN, we observed substantial heterogeneity of HBP monitoring and reporting during pregnancy and postpartum. Exact HBP reporting in the postpartum period may be related to fewer postpartum follow-up visits. With an increased focus on remote patient monitoring, digital health tools may be important for standardization of HBP monitoring in clinician reporting. Figure: Number of reports by type prenatal and postpartum. Each mention of HBP monitoring in the medical record was coded as an exact reading reported, a range of readings reported, or a qualitative report (“HBP has been within normal limits”)