(1054) Effects of a Universal Postpartum Home Visit Program on Blood Pressure Monitoring

Objective:
Despite sustained risk for hypertension-related complications, one-third to half of newly delivered patients never attend a postpartum visit. We hypothesize that implementation of a universal nurse home visit model will improve rates and timeliness of postpartum blood pressure (BP) measurements.

Study Design:
This was a retrospective cohort study of patients delivering at a single urban tertiary academic hospital in the South from 1/2024 to 1/2025. In July 2024, Family Connects (FC) was rolled out at our institution, offering delivering patients residing within city limits up to 3 home nurse visits during the postpartum period. To assess impact, we included all patients with city addresses listed at delivery admission; those delivering prior to 20 weeks gestation were excluded. July 2024 was considered a washout period and excluded from analysis. Baseline, pregnancy, and delivery characteristics were extracted from the electronic medical record, as were clinically assessed BP following delivery discharge. Primary outcome was an interrupted time series (ITS) analysis of BP assessment within 49 and 84 days of delivery. Secondary analyses evaluated time to BP assessment generating a Kaplan-Meier curve. Alpha was set at 0.05.

Results:
A total of 641 eligible pre-implementation and 703 post-implementation deliveries were identified. Cohorts were similar in age, parity, body mass index, race, ethnicity, chronic hypertension, delivery mode, and pregnancy-associated hypertension. ITS analyses at 49 and 84 days postpartum demonstrated no increase in proportion of patients with BP assessment (Figure 1, results not shown for 84 days). Median time to first postpartum BP decreased from 28 days pre-implementation to 25 days post-implementation (Figure 2).

Conclusion:
Introduction of the FC model was not associated with increased proportion of postpartum patients receiving BP assessment by 49 days postpartum, though median time to initial clinical BP was shortened following implementation.