Agreement between blood pressure from research study visits versus electronic medical records and associations with hypertensive disorder diagnoses in pregnant women with overweight/obesity.

Abstract

Blood pressure (BP) abstracted from electronic medical records (EMR) is moderately correlated to BP in nonpregnant adults with limited agreement. Little is known about the agreement of research versus EMR BP measured during pregnancy or associations of EMR BP with hypertensive disorder of pregnancy (HDP) diagnoses. BP was measured according to guidelines at in-person research study visits in 214 women with prepregnancy overweight or obesity (44.4% African American, mean age = 29.8 ± 4.8 years) at weeks 16 and 32 of pregnancy. Clinic BP readings that occurred within 1 week of the study visits were abstracted from the EMR. We assessed correlations between sources using Pearson's coefficients; the agreement was evaluated with Bland-Altman plots. We compared differences in the proportion of women with an HDP diagnosis in the EMR between women with versus without a hypertensive EMR BP measurement. SBP and DBP from study visits and the EMR were modestly moderately correlated at both time points; 0.20 < r < 0.44; P < 0.05 for all. The average mean difference was 10.5 mmHg for SBP and <1 mmHg for DBP in early and 7.3 mmHg for SBP and -1.7 mmHg for DBP in late pregnancy. Women with at least one hypertensive BP reading in the EMR were more likely to have an HDP diagnosis recorded in the EMR; 43.5 versus 3.3%; P < 0.01. EMR SBP was higher but moderately correlated with research quality BP in early and late pregnancy. Women with a hypertensive EMR BP measurement were more likely to have an HDP diagnosis in the EMR.