Key result
HDP linked to elevated later-trimester pressures despite ~46% of ABPM studies using unvalidated devices.
Why the study?
Early detection and management of hypertensive disorders during pregnancy and postpartum are essential, but the state of 24-hour ambulatory blood pressure use and its parameters for predicting hypertensive disorders of pregnancy needed evaluation.
Does 24-hour ambulatory blood pressure monitoring predict and identify Hypertensive Disorders of Pregnancy in pregnant and postpartum individuals?
Meta-Analysis
Does 24-hour ambulatory blood pressure monitoring predict and identify Hypertensive Disorders of Pregnancy in pregnant and postpartum individuals?
24-hour ambulatory blood pressure monitoring identifies elevated blood pressure in the second and third trimesters among individuals later diagnosed with hypertensive disorders of pregnancy, highlighting its potential utility despite frequent use of unvalidated devices.
Nearly half of 24-hour ABP studies in pregnancy used unvalidated devices; warrants clinical caution and challenges reliability of existing evidence.
PURPOSE: Early detection and management of hypertensive disorders during pregnancy and postpartum are essential. This systematic review and meta analysis aimed: (1) to examine the state of 24-hour ambulatory blood pressure (ABP) use, and (2) in a subset of studies, evaluate 24-hour ABP parameters in the prediction and identification of Hypertensive Disorders of Pregnancy (HDP). METHODS: A comprehensive literature search was conducted in March of 2022 for English language studies published after 2000. In a subset of studies in this review, we conducted a meta analysis summarizing 24-hour, day, and night standardized mean difference (hedge's g) in systolic and diastolic blood pressure during pregnancy for individuals later diagnosed with HDP and those without. RESULTS: A total of 69 articles met all established criteria and were included in this systematic review, and a subgroup of studies that reported HDP outcomes (n=14) were included in the meta analysis. Out of the 69 studies, 31 (45.61%) used 24-hour ABP devices that are not validated for pregnant individuals. Birthing individuals diagnosed with HDP had elevated 24-hour, day, and night systolic and diastolic blood pressure during second and third trimesters of pregnancy. CONCLUSION: A noticeable gap exists in the utilization of validated 24-hour ABP devices for pregnant and postpartum populations. Variations exist regarding the timing of 24-hour ABP measurements, particularly across trimesters. IMPLICATIONS FOR PRACTICE: 24-hour ABP monitoring could serve as one of the tools to identify and manage pregnant individuals at risk of HDP and ultimately reverse the current trend in maternal mortality.
No takes yet. Share an insight, caveat, or question.
Sommer et al. (2025) conducted a meta-analysis in Hypertensive Disorders of Pregnancy (HDP). 24-hour ambulatory blood pressure (ABP) monitoring vs. Individuals without HDP was evaluated on 24-hour, day, and night standardized mean difference in systolic and diastolic blood pressure. 24-hour ambulatory blood pressure monitoring in 69 studies revealed that 45.61% used unvalidated devices, and individuals with HDP had elevated pressures in the second and third trimesters.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: