Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared on social media

CME Credit Offered

Poster Icons

Foundation Awardee

No Social Media

Back

Q&A

Obstetric Quality and Safety

Poster Session 3

(785) Utilizing Ecological Momentary Assessment in the Postpartum Evaluation of Patients with Hypertensive Disorders of Pregnancy

Wednesday, February 14, 2024

8:30 AM – 10:00 AM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Kay Roussos-Ross, MD

University of Florida College of Medicine Gainesville
University of Florida
Gainesville, FL, United States

Coauthor(s)

Tony S. Wen, MD

Professor, Maternal Fetal Medicine Chief
University of Florida
Gainesville, FL, United States
TJ

Tianze Jiao, PhD

University of Florida
Gainesville, FL, United States
DV

Deepthi Varma, PhD

University of Florida
Gainesville, FL, United States
AG

Amie Goodin, PhD

University of Florida
Gainesville, FL, United States

Objective: Hypertensive disorders of pregnancy affect 10-20% of pregnancies, and are a leading cause of maternal mortality in the United States. A subset of women will develop worsening hypertension after delivery with resultant increased risk of morbidity and mortality. A smartphone-based application utilizing ecological momentary assessment (EMA) technology was developed for monitoring and intervention of postpartum patients with a history of hypertension in pregnancy. This innovative method allows for frequent evaluations and timely interventions of positive screens.

Study Design: A prospective study was conducted at a quaternary care academic hospital from November 2021 through June 2023. Inclusion criteria included: postpartum status, delivery of liveborn neonate, English-speaking, aged 18 and above, owning a smartphone, agreeing to download app, and prenatal diagnosis of gestational/chronic hypertension, or pre-eclampsia/eclampsia. Participants received a blood pressure cuff and were prompted to assess blood pressure via the app daily for 2 weeks, then weekly for 4 weeks. A positive screen was defined as a blood pressure > 140/90 and resulted in nurse follow-up contact.

Results: A total of 545 participants were enrolled. Clinical and demographic characteristics revealed: 57% enrolled in Medicaid, 58% white, 30% black, 15% Hispanic, 57% delivered vaginally, and 43% had Covid-19 in pregnancy. There were a total of 7,578 in-app assessments resulting in 219 positive screens (40.2% of the total enrolled) that prompted contact by the study nurse. Of positive screens, 74.9% required no referrals, 8.7% had medication adjustments/referred for clinic visit, 6.4% were sent to Labor & Delivery, and 6.4% were admitted to the hospital.

Conclusion: This smartphone-based EMA app allowed for prompt assessment and intervention of postpartum patients with hypertension, and resulted in 40.2% of participants requiring follow-up contact after an elevated blood pressure reading. Further studies are needed to assess the impact of the intervention with respect to morbidity, mortality, and health-system related cost savings.