Summary
The United States Preventive Services Task Force (USPSTF) has released an updated recommendation on screening for hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia and eclampsia, and chronic hypertension with superimposed preeclampsia. Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality in the United States.1 Both Black and Native American/Alaska Native people experience higher rates of hypertensive disorders of pregnancy compared with White people, which contribute to disparities in maternal mortality.1,2
Based on recent evidence updates, the USPSTF has found that using blood pressure measurements at each prenatal care visit to screen for hypertensive disorders in pregnancy has substantial net benefit (Grade B Recommendation). A positive screening result for new-onset hypertension during pregnancy is defined as an elevated blood pressure reading (≥ 140 / ≥ 90 in the absence of chronic hypertension) measured twice, at least 4 hours apart. Other screening methods, such as universal testing of urine for protein, were not recommended by USPSTF.1-3 Patients who screen positive should be treated using evidence-based management of hypertension in pregnancy.1 Interventions to increase provider awareness and address barriers to prenatal care have the potential to reduce adverse pregnancy outcomes.3
Sources
1US Preventive Services Task Force. Screening for hypertensive disorders of pregnancy: US Preventive Services Task Force final recommendation statement. JAMA. 2023;330(11):1074-1082. doi:10.1001/jama.2023.16991.
2Henderson JT, Webber EM, Thomas RG, Vesco KK. Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2023;330(11):1083-1091. doi:10.1001/jama.2023.4934.
3Agency for Healthcare Research and Quality (US): Henderson JT, Webber EM, Vesco KK, Thomas RG. Screening for hypertensive disorders of pregnancy: an evidence update for the U.S. Preventive Services Task Force (Evidence Synthesis, No. 227). https://www.ncbi.nlm.nih.gov/books/NBK595102/. Published September 2023. Accessed December 21, 2023.