Self-monitoring of blood pressure among women with hypertensive disorders of pregnancy: a systematic review.
BMC Pregnancy Childbirth
; 22(1): 454, 2022 May 31.
Article
in English
| MEDLINE | ID: covidwho-1951113
ABSTRACT
BACKGROUND:
The World Health Organization (WHO) recommends self-monitoring of blood pressure (SMBP) for hypertension management. In addition, during the COVID-19 response, WHO guidance also recommends SMBP supported by health workers although more evidence is needed on whether SMBP of pregnant individuals with hypertension (gestational hypertension, chronic hypertension, or pre-eclampsia) may assist in early detection of pre-eclampsia, increase end-user autonomy and empowerment, and reduce health system burden. To expand the evidence base for WHO guideline on self-care interventions, we conducted a systematic review of SMBP during pregnancy on maternal and neonatal outcomes.METHODS:
We searched for publications that compared SMBP with clinic-based monitoring during antenatal care. We included studies measuring any of the followingoutcomes:
maternal mortality, pre-eclampsia, long-term risk and complications, autonomy, HELLP syndrome, C-section, antenatal hospital admission, adverse pregnancy outcomes, device-related issues, follow-up care with appropriate management, mental health and well-being, social harms, stillbirth or perinatal death, birthweight/size for gestational age, and Apgar score. After abstract screening and full-text review, we extracted data using standardized forms and summarized findings. We also reviewed studies assessing values and preferences as well as costs of SMBP.RESULTS:
We identified 6 studies meeting inclusion criteria for the effectiveness of SMBP, 6 studies on values and preferences, and 1 study on costs. All were from high-income countries. Overall, when comparing SMBP with clinic-monitoring, there was no difference in the risks for most of the outcomes for which data were available, though there was some evidence of increased risk of C-section among pregnant women with chronic hypertension. Most end-users and providers supported SMBP, motivated by ease of use, convenience, self-empowerment and reduced anxiety. One study found SMBP would lower health sector costs.CONCLUSION:
Limited evidence suggests that SMBP during pregnancy is feasible and acceptable, and generally associated with maternal and neonatal health outcomes similar to clinic-based monitoring. However, more research is needed in resource-limited settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021233839 .Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pre-Eclampsia
/
Hypertension, Pregnancy-Induced
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
Language:
English
Journal:
BMC Pregnancy Childbirth
Journal subject:
Obstetrics
Year:
2022
Document Type:
Article
Affiliation country:
S12884-022-04751-7
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