The US Preventive Services Task Force (USPSTF) has issued updated recommendations regarding the screening for hypertensive disorders of pregnancy. The final recommendation statement, published on September 19, 2023, underscores the importance of blood pressure measurements throughout pregnancy as an effective screening method for hypertensive disorders. This recommendation has been awarded a B grade, signifying high certainty that the net benefit is moderate or that there is moderate certainty the net benefit is moderate to substantial.
Dr. Esa Davis, a member of the USPSTF and professor of medicine and family and community medicine at the University of Maryland School of Medicine, emphasized the effectiveness of measuring blood pressure at each prenatal visit for screening hypertensive disorders. Given the potential serious health issues associated with these conditions, routine screening plays a crucial role in safeguarding the health of both pregnant individuals and their babies.
This recommendation applies universally to all pregnant women and pregnant individuals of all genders who do not have a known diagnosis of a hypertensive disorder of pregnancy or chronic hypertension.
The updated guidance aligns with the USPSTF’s 2017 recommendation statement on screening for preeclampsia and is grounded in a targeted systematic review of evidence pertaining to the efficacy of screening for hypertensive disorders of pregnancy. The review involved an examination of six studies, encompassing 10,165 individuals, that compared changes in prenatal screening practices with usual care. These studies explored various screening methods, including home blood pressure measurement and reduced prenatal visit schedules.
While the studies did not report statistically significant differences in maternal and infant complications with alternate screening strategies compared to usual care, it’s important to note that estimates for rare health outcomes were imprecise. Additionally, home blood pressure measurement did not lead to earlier diagnosis of hypertensive disorders of pregnancy when added to prenatal care visits. Importantly, no harms associated with different screening strategies were identified.
The USPSTF, through this recommendation, highlights the need for further research in addressing health disparities related to hypertensive disorders of pregnancy, especially among Black, Native American, and Alaska Native patients who face inequities in this regard.
The final recommendation statement underscores the importance of evidence-based management for individuals who screen positive for hypertensive disorders of pregnancy. This recommendation is intended to serve as a catalyst for increased efforts at various levels, including government, communities, healthcare systems, and individuals and families, to reduce risk factors, devise innovative screening and treatment approaches, and promote the recognition of warning signs, all in an effort to address the broader maternal health crisis.
