(290) Better maternal and fetal outcomes in women with self-monitoring of blood pressure and telemedicine visit

Objective: Hypertensive disorders of pregnancy (HDP) affect 13% of pregnancies in the United States. Without monitoring, HDP can rapidly develop and progress. Self-monitoring of blood pressure (SMBP) for timely detection and treatment of HDP in the United States is still limited. We examined maternal and fetal outcomes and health utilization rates among pregnant women with SMBP and telemedicine visits (SMBP+T) and pregnant women with usual care (UC).

Study Design: This multicenter, retrospective cohort study (from 2020 to 2022) included women aged 15-55 years with singleton pregnancies; no prior diabetes, gestational diabetes, or HDP; and no use of low-dose aspirin in prior pregnancies. Women were excluded if there was insufficient information, a severe mental health diagnosis, drug use complicating pregnancies or termination of healthy, viable pregnancies. Eligible women with SMBP and telemedicine visits (n=533) during prenatal care were assigned to the SMBP+T group. Another matched cohort of eligible women (n=533) was comprised of the UC group that received only in-person office visits during prenatal care.

Results: At baseline, the sociodemographic, body mass index, comorbidities, history of prior pregnancy outcomes and blood pressure levels were similar across groups (Table 1). During pregnancy, groups had similar rates of new onset of HDP, delivery modes, gestational ages at delivery and pregnancy outcomes such as term birth, preterm birth, and pregnancy termination. In the UC group, those with HDP had higher incidents of maternal cardiovascular events (16.9% UC vs 7.1% SMBP+T; p < 0.05) and fetal complications related to HDP (29.6% UC vs 17.1% SMBP+T; p < 0.05). In addition, the UC group visited a prenatal office at slightly higher frequency (68.9% UC vs 62.3% SMBP+T; p < 0.05).

Conclusion: SMBP with telemedicine visits during pregnancy was associated with lower rates of maternal cardiovascular events and fetal complications related to HDP. SMBP with telemedicine visits also did not increase health utilization rate in low-risk pregnant women.