New study highlights gap in postpartum blood pressure screening

In a new study, only 13.7% of women diagnosed with hypertensive disorders of pregnancy (HDP) attended a blood pressure screening visit within 10 days of delivery. HDP can cause life-threatening complications, as described in the study published in the peer-reviewed Journal of Women's Health.

The American College of Obstetricians and Gynecologists recommends that women with HDP undergo blood pressure screening 7-10 days after delivery to detect postpartum hypertension, or earlier if symptoms develop.

Sheree Boulet, DrPH, MPH, from Emory University School of Medicine, and coauthors conducted a population-based study of pregnant women who delivered at a large public hospital in Atlanta, GA and identified demographic and clinical predictors of postpartum blood pressure (BP) screening attendance among women with HDP. They found that women with preeclampsia with severe features were more likely to attend a BP visit than women with gestational hypertension. Furthermore, rates of BP screening attendance were lower for women with inadequate and intermediate prenatal care utilization compared to women with adequate prenatal care utilization.

"These findings suggest that we have a long way to go in improving BP screening attendance," state the authors. "Addressing the gap in postpartum BP screening will require creative solutions to address barriers at the individual-, provider-, and systems-levels."

Despite the ACOG recommendation that women with HDP undergo BP screening within 7-10 days of delivery, the women have to show up for this visit. This study demonstrates the missed opportunity to screen these high-risk women and avoid the potentially serious complications of postpartum hypertension."

Susan G. Kornstein, MD, Journal of Women's Health Editor-in-Chief, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA