Incorporating Maternal Blood Pressure Screening Into Routine Newborn Clinic Visits

Abstract

Background and ObjectivesIn the immediate postpartum period, mothers often prioritize newborn care over postpartum follow-up. There is an increasing contribution of hypertensive disorders of pregnancy (HDP) to maternal morbidity and mortality. In this feasibility study, we sought to implement maternal postpartum blood pressure (BP) screening in a newborn clinic. MethodsWe conducted a non-randomized, prospective feasibility study to evaluate the application of maternal BP screening at newborn clinic visits. An elevated BP was defined as a systolic pressure (SBP) of ≥140 mmHg or a diastolic pressure (DBP) of ≥90 mmHg. BPs were triaged with a standardized algorithm, utilizing support and expertise of on-call maternal subspecialists. ResultsWe screened 72 postpartum individuals, with a mean SBP of 130±19 mmHg and DBP 86±12 mmHg. Most were publicly insured (78%) and self-identified as Black (69%). Of the 31 (43%) with an elevated BP, 13 (42%) did not have a known HDP. Of those without known HDP, 4 were diagnosed with postpartum preeclampsia and 2 with postpartum hypertension. One individual diagnosed with new-onset postpartum preeclampsia was triaged to the emergency department. Only 56% of women attended a obstetrics appointment within 12 weeks after delivery. ConclusionsThis study demonstrates the feasibility of an innovative maternal postpartum BP assessment in a racially and socioeconomically diverse pediatrics clinic. Through collaborative care, individuals were able to be safely triaged, thus providing an opportunity to identify at-risk individuals who could benefit from earlier identification and management of hypertension. Pediatricians have a unique opportunity to contribute to postpartum maternal health.