Feasibility of Postpartum Blood Pressure Monitoring for Hypertensive Disorders in a Low-Resource Setting.

BACKGROUND

Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal health globally, especially in Nigeria, which has the highest maternal mortality rate. Home blood pressure (BP) monitoring is a promising approach for managing HDP.

OBJECTIVES

This study assessed the feasibility of a postpartum home BP-monitoring program for women with HDP in low-resource settings like Nigeria, focusing on recruitment, retention, and fidelity to monitoring protocols. HDP diagnoses associated with persistent hypertension were also assessed.

METHODS

Participants with HDP were enrolled into a prospective cohort. They were educated on BP monitoring and transmitted daily BP readings for 2 weeks. A control group of healthy postpartum women was also enrolled. The 12-week study involved assessments at prespecified intervals.

RESULTS

The study met its target of 90 participants (mean age: 30 years) and had high fidelity (96%) to daily BP recordings and retention (94%) at 12 weeks. The mean systolic BP decreased from 137 mm Hg to 125 mm Hg, and the mean diastolic BP decreased from 89 mm Hg to 84 mm Hg. During the initial 2-week period, 81.1% of normotensive participants experienced elevated BP, with 86.5% showing elevated BP over 12 weeks. In addition, 22% reported adverse cardiovascular events.

CONCLUSIONS

The study demonstrates the feasibility of a postpartum BP-monitoring program in a low-resource setting like Nigeria, with high recruitment, fidelity, and retention. Continued monitoring beyond the immediate postpartum period is essential for improving outcomes. Further research is needed to evaluate the long-term effectiveness and scalability of such programs.