U.S. Preventive Services Task Force recommends blood pressure measurement throughout pregnancy

The U.S. Preventive Services Task Force (USPSTF) recommends all pregnant people undergo blood pressure measurement throughout pregnancy to identify hypertensive disorders of pregnancy (Grade B recommendation). This recommendation forms the basis of a draft recommendation statement published online Feb. 7.

Jillian T. Henderson, Ph.D., M.P.H., from Kaiser Permanente Evidence-based Practice Center in Portland, Oregon, and colleagues conducted a systematic review to compare different approaches for screening for hypertensive disorders of pregnancy. Five randomized controlled trials and one nonrandomized study of interventions were included; three types of screening strategies were compared to usual screening programs. The researchers found that in a trial that incorporated home blood pressure measurement into prenatal care, the proportions of maternal complications related to hypertensive disorders of pregnancy was similar in the home measurement and usual care group. The intervention was not associated with increased anxiety. Based on two trials, having fewer prenatal visits was not associated with better or worse pregnancy outcomes. In a study comparing indicated versus routine urine screening, diagnoses of hypertensive disorders of pregnancy did not differ after implementation of indicated screening.

Based on these findings, the USPSTF recommends screening asymptomatic pregnant persons for hypertensive disorders throughout pregnancy with blood pressure measurements. To achieve the benefit of screening, persons who screen positive should receive evidence-based hypertensive disorders of pregnancy management.

The draft evidence review and draft recommendation statement are posted for public comment. Comments can be submitted from Feb. 7 through March 6, 2023.

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