The US Preventive Services Task Force (USPSTF) has issued a crucial recommendation stating that all pregnant individuals, including those without a known history of hypertensive disorders, should undergo comprehensive blood pressure monitoring throughout their pregnancy. This recommendation aims to address disorders such as gestational hypertension and preeclampsia, and it was published in the medical journal JAMA.
Hypertensive disorders of pregnancy encompass conditions like chronic hypertension, gestational hypertension, preeclampsia, and eclampsia, all of which can have severe implications for maternal health. The USPSTF, a group of independent volunteer medical experts known for providing guidance to healthcare professionals, underscored the importance of monitoring blood pressure as a screening tool for high blood pressure-related disorders during pregnancy.
Preeclampsia, in particular, is a serious condition that typically emerges after 20 weeks of pregnancy, more commonly in the third trimester, and can impact multiple organs in the body, potentially leading to seizures and strokes.
Dr. Esa Davis, a member of the task force and senior associate dean for population health and community medicine at the University of Maryland in Baltimore, emphasized the urgency of this recommendation, considering the current maternal health crisis in the US. The nation faces high rates of maternal deaths and complications occurring during and shortly after pregnancy, with hypertensive disorders of pregnancy being a leading cause.
While blood pressure measurements are already a routine part of prenatal visits, the official recommendation emphasizes the importance of this practice. Moving forward, pregnant individuals may notice increased attention to blood pressure during routine healthcare appointments.
The USPSTF hopes that heightened monitoring will reduce the risk of undiagnosed or untreated hypertensive disorders during pregnancy. Regular blood pressure assessments are considered the optimal tool for identifying and preventing these disorders.
This recommendation emerged following a review of data from studies conducted between January 2014 and January 2022, which examined various methods of screening for hypertensive disorders of pregnancy.
Hypertensive disorders during pregnancy are on the rise in the United States. Between 2017 and 2019, the prevalence of these disorders among hospital deliveries increased from 13.3% to 15.9%, affecting at least 1 in 7 deliveries. Notably, about 1 in 3 deaths during hospital deliveries involved a documented diagnosis of hypertensive disorder during pregnancy.
The risk of these disorders is higher for older women, Black women, American Indian and Alaska Native women. It is closely linked to social determinants of health and access to care, including income, housing, and access to healthy food.
The USPSTF did not make a recommendation regarding blood pressure monitoring after pregnancy, citing insufficient evidence. However, patients are advised to seek medical attention if they experience symptoms like headaches, blurred vision, shortness of breath, or leg swelling. They can also monitor their blood pressure at home post-pregnancy.
The task force encourages guidance on identifying the signs and symptoms of hypertensive disorders of pregnancy upon discharge from the hospital and urges patients to reach out to their healthcare providers if necessary.
