(513) Characteristics Associated with Compliance Within a Postpartum Hypertension Remote Monitoring Program

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Jenny Y. Mei, MD (she/her/hers)

Clinical Assistant Professor
Stanford University
Mountain View, California, United States

Coauthor(s)

Audra Fain, MD (she/her/hers)

Resident Physician
University of California, Los Angeles
Los Angeles, California, United States
KC

Kate Corry-Saavedra, MD

Resident Physician
University of California, Irvine
University of California, Irvine, California, United States
TN

Tina A. Nguyen, MD

Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States
Thalia Mok, MD

Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States
AM

Aisling M. Murphy, MD

Assistant Professor
University of California, Los Angeles
Los Angeles, California, United States

Objective: Remote blood pressure (BP) monitoring has been shown to decrease postpartum Emergency Department (ED) visits and readmissions. We evaluate characteristics associated with compliance within a remote BP monitoring program.

Study Design:

A retrospective cohort study of birthing patients with peripartum hypertension (HTN) at a quaternary care center over 2 years. This study is part of an ongoing postpartum quality improvement project that entails lower BP targets and universal remote BP monitoring. Inclusion criteria were delivery at the study institution and diagnosis of HTN disorder of pregnancy at time of discharge. Primary outcome was compliance with utilizing remote BP monitoring, defined as logging at least one BP within the program. We compared maternal and hypertensive characteristics between groups.

Results: Out of 6410 deliveries between April 2022-April 2024, 2019 (31.5%) pregnancies met inclusion criteria, of which 1509 (74.7%) were compliant with utilizing remote BP monitoring. There were higher rates of compliance with higher maternal age (in years, 34.2±5.0 vs 33.0±6.3, p< 0.001), nulliparity (71.2% vs 56.5%, p< 0.001), lower BMI (in kg/m², 30.2±6.1 vs 31.6±7.0, p< 0.001), prenatal aspirin use (41.9% vs 33.1%, p< 0.001), IVF pregnancy (12.3% vs 7.8%, p=0.006), and private insurance (84.9% vs 59.4%, p< 0.001). Patients discharged on anti-hypertensive medication were more likely to be compliant (36.0% vs 24.1%, p< 0.001) as were those with longer postpartum lengths of stay (in days, 2.4±1.3 vs 2.3±1.2, p=0.027). Compliance was associated with lower rate of ED visit or readmission (1.8% vs 3.3%, p=0.039).

Conclusion: Characteristics that are associated with higher rates of compliance with remote BP monitoring include nulliparous, older, and privately insured patients. Compliance was associated with lower rates of postpartum ED visit or readmission. Continued work is needed to identify barriers to remote BP monitoring and target these areas for improvement within programs to improve compliance and further decrease postpartum readmission rates.