Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
Authors' conclusion
This review did not identify evidence that any alternative screening strategies for hypertensive disorders of pregnancy were more effective than routine blood pressure measurement at in-person prenatal visits.
Study context
- Population
- Pregnant or postpartum individuals6 studies (5 trials, 1 nonrandomized)
- Participants
- 10,165 participants
- Comparison
- Alternative prenatal screening strategies vs usual care
- Home blood pressure measurementn = 2,521
- Reduced prenatal visit schedulesn = 5,203
- Proteinuria screeningn = 2,441
- Outcome
- Morbidity or mortality, measures of health-related quality of life
Methodological detailstargeted systematic review, no quantitative synthesis
- Targeted systematic review
- No quantitative synthesis
Pooled result
As reported in the abstract
Maternal and infant complications
- No statistically significant differences in maternal and infant complications with alternate strategies vs usual care; estimates imprecise for serious, rare outcomes
- No quantitative synthesis
Further pooled results
| Outcome | Home blood pressure measurement | Reduced prenatal visit schedules | Proteinuria screening | Usual care | |
|---|---|---|---|---|---|
| Time to diagnosis of a hypertensive disorder of pregnancy (home BP measurement) | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | 106.2 days | Home blood pressure measurement, Reduced prenatal visit schedules, Proteinuria screening: not reported in the abstract |
- Time to diagnosis of a hypertensive disorder of pregnancy (home BP measurement): Home BP measurement 104.3 days
Time to diagnosis of a hypertensive disorder of pregnancy (home BP measurement)
- Not associated with earlier diagnosis
Incidence of hypertensive disorders of pregnancy (reduced visit schedules)
- Incidence not different between groups in 3 trials
Postpartum screening for new-onset hypertensive disorders
- No studies addressed screening in the postpartum period
Safety
Harms of screening strategies
- No harms of the different screening strategies were identified
- 1 additional trial (n = 80) addressed harms of home BP measurement only
Original publication
Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. Published 19 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it