Task Force Recommends Frequent Blood Pressure Screening During Pregnancy

WASHINGTON — The U.S. Preventive Services Task Force issued draft recommendations on Tuesday calling for stepped up screening for hypertensive disorders during pregnancy — especially for Black and Native American women.

A copy of the recommendation as well as a request for public comment have been published on the task force’s website. The comment period ends at 11:59 p.m. on March 6.

The recommendations come at a time of increasing concern over an apparent increase in maternal mortality in the United States.

In addition to calling on health care providers to be more vigilant in their care of pregnant women of color, the task force is hoping to spur more research into the conditions that appear to be contributing to the mortality rate.

The task force is made up of 16 volunteer members who are nationally recognized experts in prevention, evidence-based medicine and primary care.

They are appointed to the panel by the director of the Agency for Healthcare Research and Quality — one of 12 agencies within the U.S. Department of Health and Human Services — and serve four-year terms.

Before issuing their recommendations, the task force reviewed 6,316 abstracts and assessed 82 full-text articles. 

Studies considered for inclusion were randomized controlled trials and non-randomized studies of interventions comparing screening interventions conducted with pregnant and postpartum people, including those at increased risk for hypertensive disorders of pregnancy. 

Interventions and comparisons of interest included: blood pressure measurement setting (office or home), interval, frequency, or timing; proteinuria assessment setting, interval, or sequence of testing; and personalization of screening based on risk assessment.

The panel concluded: “Screening for hypertensive disorders of pregnancy with standard of care office-based blood pressure measurement can identify individuals requiring further surveillance and evidence-based clinical management to decrease risks for related adverse pregnancy outcomes. 

“Research is needed to develop and strengthen clinical screening and management, possibly incorporating telehealth, home-based blood pressure measurement, and postpartum screening. 

“Addressing troubling and persistent health inequities related to hypertensive disorders of pregnancy among specific populations in the U.S. — especially Black and American Indian/Alaska Native people — will require interventions at multiple levels, including policies, health systems, and clinical practices,” it said.

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