EP01.56: Postpartum remote blood pressure monitoring and risk of hypertensive related readmission: systematic review and meta‐analysis of RCTs

To assess the efficacy of remote blood pressure monitoring and telehealth strategies at preventing readmission due to complications of hypertensive disorders of pregnancy. The search was conducted using MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID up to March 2024. Selection criteria included RCTs of postpartum individuals randomised to remote blood pressure monitoring or telehealth strategies vs. routine care. The primary outcome was postpartum readmission due to hypertensive complications, defined as hospital admission after discharge in the postpartum period. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence intervals (CI) using the random effects model of DerSimonian and Laird. I-squared (Higgins I2) greater than 0% was used to identify heterogeneity. Four RCTs including 714 individuals randomised to either telematic reporting of blood pressure measurements (49.8%) or standard postpartum care with in office blood pressure measurements at the time of postnatal visits (50.1%) There were no significant differences in the rate of hospital readmission due to hypertensive related causes (5.3% vs 11.8% RR 0.56 95% CI 0.18-1.70 p = 0.30). However, emergency department visit rate differed significantly among the two groups (9.0% vs 4.4% RR 2.04 95% CI 1.01, 4.09 p = 0.05). With regards to postpartum follow up: blood pressure assessment at 10 days postpartum was similar between both groups (90.4% vs 70.1% RR 1.34 95% CI 0.72-2.48 p = 0.35), and the 4-6 weeks postpartum visit attendance rate was also similar (82.6% vs 75.9% RR 1.06 95% CI 0.98, 1.14 p = 0.17). No included RCT provided data on maternal secondary outcome like pulmonary edema, stroke, maternal death and ICU admission. Remote blood pressure monitoring is not effective compared to standard care to prevent hypertensive related readmission and increases emergency department visits.