(320) Postpartum Hypertension Screening at Newborn Visits and Impact on Postpartum Outcomes

Objective: To assess how a novel maternal postpartum hypertension (HTN) screening program at newborn visits partnered with a remote blood pressure (BP) management program would impact maternal care utilization and outcomes.

Study Design: This is a prospective quality improvement initiative with previously described feasibility at a large academic primary care center that serves a majority non-White (68%) and publicly insured (77%) population. Maternal vital sign screening was performed by pediatric clinic staff. Elevated BP (≥ 140/90 mmHg) triggered algorithms that involved contacting an on-call Maternal-Fetal Medicine or Cardiology physician and/or enrollment into a remote BP management program. Controls were postpartum individuals with newborns receiving care at the same clinic on days when screening was not offered. Postpartum outcomes and care utilization data were compared between the two groups.

Results: Of 140 screened individuals and 248 controls, the screened group was more likely to be diagnosed with new postpartum HTN (16.0% vs. 8.2%; p= 0.049). The screened group was more likely to be initiated on anti-hypertensive medication postpartum (31.0% vs. 26.0%; p=0.56) and had lower rates of Emergency Department (ED) visits (17.9% vs. 25.0%; p=0.11) and readmissions (5.7% vs. 8.5%; p=0.32) compared with controls, though not statistically significant. Postpartum visit rates were similar between groups (65.7% vs. 65.7%; p=1.0).

Conclusion: Maternal HTN screening in a newborn clinic partnered with a remote BP management program was associated with higher diagnostic rates of postpartum HTN with subsequent treatment, without concomitant increases in ED visits or readmissions among a racially and socioeconomically diverse population. Screening for postpartum HTN during newborn visits may improve diagnosis and treatment of postpartum HTN in an at-risk population, however, more targeted interventions are likely needed to increase attendance at postpartum visits.