This week, we summarize a new study in obstetric hypertension and remote blood pressure monitoring in pregnancy. The study, conducted by researchers at Kaiser Permanente of Georgia, is the largest study in remote patient monitoring for obstetric hypertension. Researchers examined 937 pregnant patients from diagnosis through 6 weeks postpartum to see whether a remote blood pressure monitoring program could improve outcomes compared to historical controls.
This next section explores obstetric hypertension, the alarming maternal mortality rates in the United States, the escalating challenges faced by pregnant patients, and the associated health risks.
Obstetric Hypertension in the United States
Maternal mortality rates in the United States remain alarmingly high, with severe maternal morbidity on the rise. In 2019, there were 20.1 maternal deaths per 100,000 live births. This rate rose to 23.8 deaths per 100,000 live births in 2020. Most recently, data from 2021 indicates the maternal mortality rate has continued climbing to 32.9 deaths for every 100,000 live births.
Obstetric hypertension contributes significantly to these statistics. Hypertension, also called high blood pressure, can lead to health issues at any point in life. Usually, asymptomatic hypertension during pregnancy that is uncontrolled or severe may cause complications for both mother and fetus.
Some women have pre-existing high blood pressure before pregnancy, while others develop it for the first time while pregnant. During pregnancy, the body creates more blood to support the growth of the fetus. If blood pressure increases during pregnancy, it can stress the heart and kidneys.
This stress can lead to heart disease, kidney disease, or even stroke. High blood pressure during pregnancy also increases the risk of preeclampsia, preterm birth, placental abruption, and cesarean birth. Preeclampsia, a serious hypertensive disorder, can also occur during pregnancy or soon after delivery.
Obstetric Hypertension Study Overview
The Kaiser Permanente healthcare team used the Cocoon Pregnancy Care Model that integrated telehealth, remote patient pregnancy monitoring, and psychosocial support into routine prenatal care. A remote patient monitoring hypertensive disorders of pregnancy program (RPM HTN) was designed for pregnant or postpartum women diagnosed with or at high risk for developing obstetric hypertension. The RPM HTN program provided daily remote blood pressure monitoring in pregnancy and postpartum patients diagnosed with chronic hypertension or pregnancy-induced hypertension.
The goal was to track blood pressure more closely outside the clinical setting and intervene more rapidly when abnormal readings occurred. The patients transmitted home readings to their physicians with remote patient monitoring medical devices. Abnormal readings triggered contact with a qualified healthcare professional who worked with patients and their doctors to adjust treatment as needed.
Improving Postpartum Blood Pressure Control
The study included 1,030 patients enrolled in the RPM HTN compared to 937 matched historical controls. Additionally, 50.2% of the RPM HTN cohort enrolled during the antepartum period, and 49.8% enrolled postpartum. The researchers concluded the following about the program for obstetric hypertension management: “A remote HTN monitoring program for 937 obstetric patients was associated with improved BP monitoring, better postpartum BP control, and improved linkages to clinician care after delivery when compared to historical controls.”
Key findings from the study showed:
- Post-hospital discharge remote blood pressure monitoring in pregnancy improved, with a 1.56-fold increase in measurements within the first 20 days after delivery.
- Postpartum blood pressure control saw a 1.43-fold increase in normal readings. Patients in the RPM HTN cohort were 1.27 times more likely to be on antihypertensives postpartum and 1.50 times more likely to be evaluated by an obstetric clinician within 20 days of delivery.
Remote Blood Pressure Monitoring in Pregnancy for Obstetric Hypertension
This study represents the largest-scale remote obstetric hypertension program using remote blood pressure monitoring in pregnancy. The research demonstrates the effectiveness of providing daily remote blood pressure monitoring from HDP diagnosis in the antepartum or postpartum period until six weeks postpartum. The program’s success is attributed to KPGA’s integrated medical system, electronic medical records (EMR), and supportive elements within the Cocoon Pregnancy Care Model.
The study’s findings underscore the potential of remote blood pressure monitoring to improve postpartum blood pressure control and strengthen linkages to clinician care after delivery. As the U.S. grapples with escalating maternal mortality rates, this research offers a replicable model for other clinical settings to adapt and implement, potentially revolutionizing care in women’s health and for pregnant women diagnosed with hypertensive disorders. Additionally, it shows promise to help address maternal mortality related to obstetric hypertensive disorders. To subscribe to Tenovi’s Weekly Research Newsletter, scroll down and find the subscription link below. If you are part of a chronic care management, telehealth, or RPM software and services company, explore Tenovi RPM solutions. Book your free demo and consultation with us today.
