The study found that remote monitoring of postpartum hypertension was associated with fewer readmissions, increased adherence to national guidelines, and initiation of antihypertensive medications for individuals with hypertensive disorders of pregnancy (HDP).
Hypertension complicates 10-20% of pregnancies, and is a significant contributor to maternal mortality and morbidity, especially in the postpartum period when the majority of deaths occur.
It's also the most common cause of postpartum readmission. Worsening hypertension often doesn't manifest until after hospital discharge, and BP levels can also vary widely over the postpartum period, necessitating frequent medication titrations.
To manage these risks, ACOG recommends that individuals with HDP have their blood pressure measured at 10 days after delivery, but attendance rates at these recommended visits are low. Women that have just given birth and may have other children at home are not likely to prioritize a check-in, and in fact, less than 50% attend these in-office BP checks.
Black women are at higher risk than their White peers during this period. They are less likely to return to pre-pregnancy BP levels, and they are also less likely to attend a follow-up postpartum appointment. According to one study, visit adherence was 63.9% for Black patients compared with 88.7% for their non-Black peers.
A recent systematic review shows that remote blood pressure monitoring improves blood pressure ascertainment in this vulnerable period.
In a study using Babyscripts, patients with remote monitoring had higher rates of postpartum blood pressure ascertainment compared with in-office surveillance (91.7% vs 58.4%), and remote monitoring also eliminated racial disparities observed at in-office checks. Black patients had lower rates of blood pressure ascertainment than White patients when assigned to in-office surveillance (41.2% vs 69.5%), but there was no difference in the remote management group (92.9% vs 92.9%). [1]
The connection between remote BP monitoring and BP ascertainment has been well-established, but its effect on outcomes has been less clear. This study affirms the downstream effects of RPM for blood pressure on clinical outcomes, demonstrating an association between remote BP monitoring and postpartum care utilization, attendance at a postpartum visit, and initiation of antihypertensive medications within 6 weeks postpartum.
These findings confirm results observed at LCMC Health, where use of Babyscripts' RPM was shown to drive higher compliance to postpartum care. Providers at LCMC Health found that offering continuous digital touchpoints and ongoing education and reminders during the postpartum period through Babyscripts drove up rates of postpartum visit attendance. In an analysis between Babyscripts users and a control group at LCMC Health, Babyscripts users were more than two times as likely to complete a postpartum visit in the first 30 days following delivery than the control group. By 60 days postpartum, 64% of Babyscripts users had completed a postpartum visit, compared to 44% of the control group. [2]