Patient-Reported Depression in Women Participating in Remote Patient Monitoring for Postpartum Hypertension [25L

Abstract

INTRODUCTION: Depression is prevalent in the postpartum period. We evaluated patient-reported symptoms of depression during the 6-week postpartum period, among women at risk for severe hypertension (≥150/100 mm Hg) who were participating in a pilot intervention for remote-monitoring of women with hypertensive disorders following discharge. METHODS: This intervention included women with a hypertension-related diagnosis during or after pregnancy. Upon discharge, patients received a table device and equipment to transmit home vital signs daily and answer a series of scheduled questions regarding symptoms associated with hypertension and mood for up to 6 weeks postpartum. Bi-weekly, the patients were asked, if their “mood had been more depressed this week compared with a normal week.” RESULTS: 11/51 women (22%) reported their mood was more depressed than normal during the first 6 weeks postpartum. Of these patients, 3/11 (27%) had gestational hypertension, 3/11 (27%) chronic hypertension, and 6 (55%) preeclampsia. 6/11 patients reported having a more depressed mood during week 1; this persisted during week 2 or later in only 2 patients. 4/11 patients denied feeling depressed during postpartum week 1, but later endorsed these symptoms. CONCLUSION: Preliminary results demonstrated a high proportion of self-reported depressed mood among postpartum patients with a pregnancy-related hypertensive disorder. This was more prevalent in women with preeclampsia, and highest in the early postpartum period. Use of remote monitoring is a promising strategy for monitoring postpartum hypertension as well as other associated symptoms including depressed mood after discharge. Our findings warrant further investigation on effective monitoring and delivery of prompt treatment of postpartum depression.