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Postpartum home blood pressure monitoring and lifestyle intervention in the first year after a hypertensive disorder of pregnancy: A pilot feasibility trial
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  • Alisse Hauspurg,
  • Ellen Seely,
  • Janet Rich-Edwards,
  • Christina Hayduchok,
  • Samantha Bryan,
  • Andrea Roche,
  • Arun Jeyabalan,
  • Esa Davis,
  • Renee Hart,
  • Jada Shirriel,
  • Janet Catov
Alisse Hauspurg
University of Pittsburgh School of Medicine

Corresponding Author:janickia@upmc.edu

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Ellen Seely
Brigham and Women's Hospital
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Janet Rich-Edwards
Harvard T.H. Chan School of Public Health
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Christina Hayduchok
University of Pittsburgh School of Medicine
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Samantha Bryan
University of Pittsburgh School of Medicine
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Andrea Roche
Brigham and Women's Hospital
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Arun Jeyabalan
University of Pittsburgh School of Medicine
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Esa Davis
University of Pittsburgh School of Medicine
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Renee Hart
University of Pittsburgh School of Medicine
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Jada Shirriel
Healthy Start, Inc
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Janet Catov
University of Pittsburgh School of Medicine
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Abstract

Objective: To test the feasibility of a randomized trial of home blood pressure monitoring paired with a remote lifestyle intervention vs. home blood pressure monitoring alone vs. control in individuals with a hypertensive disorder of pregnancy in the first year postpartum. Design: Single-blinded randomized clinical trial Setting: Two tertiary hospitals and a community organization Population: Overweight and obese individuals with a hypertensive disorder of pregnancy and without pre-pregnancy hypertension or diabetes. Methods: We assessed the feasibility of recruitment and retention of 150 participants to study completion at one-year postpartum with randomization 1:1:1 into each arm. Secondary aims were to test effects of the interventions on weight, blood pressure and self-efficacy. Results: Over 23 months, we enrolled 148 of 400 eligible, screened individuals (37%); 28% Black or Other race, and mean pre-pregnancy BMI of 33.4±6.7 kg/m2. In total, 129 (87%) participants completed the one-year postpartum study visit. Overall, 22% of participants developed stage 2 hypertension [≥140/90 mmHg or on anti-hypertensive medications] by one-year postpartum. Individuals in the lifestyle intervention arm had a greater, non-significant decrease in mean arterial pressure (MAP) compared to individuals in the HBPM alone and control arm [mean change in MAP (95%CI) -3.7(-6.5, -0.9), -0.5(-1.5, 2.6), -1.0(-4.1, 2.2) mmHg], respectively. There were no differences in weight or self-efficacy by study arms. Conclusion: In this pilot, randomized trial, we demonstrate feasibility of HBPM paired with a lifestyle intervention in the first year postpartum. We detected high rates of ongoing hypertension emphasizing the need for effective interventions in this population.
22 Apr 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
26 Apr 2022Submission Checks Completed
26 Apr 2022Assigned to Editor
12 May 2022Reviewer(s) Assigned
29 May 2022Review(s) Completed, Editorial Evaluation Pending
13 Aug 2022Editorial Decision: Revise Major
14 Sep 20221st Revision Received
03 Oct 2022Submission Checks Completed
03 Oct 2022Assigned to Editor
03 Oct 2022Review(s) Completed, Editorial Evaluation Pending
02 Nov 2022Editorial Decision: Accept