(1174) Differences in Engagement and Outcomes in a Postpartum Hypertension Monitoring Program by Infant NICU Admission

Remote self-measured blood pressure (SMBP) monitoring programs improve outcomes in the postpartum period among individuals with hypertensive disorders of pregnancy (HDP). However, whether those findings are impacted by infant neonatal intensive care unit (NICU) admission is unknown. Our objective is to examine if infant NICU admission is associated with differences in engagement and outcomes among SMBP program participants.

Study Design:

Postpartum individuals with HDP at our tertiary hospital are offered enrollment in our remote SMBP program. For this analysis, participants were stratified by those with infants admitted to the NICU or to the standard newborn nursery. The primary outcome was engagement in our SMBP as assessed by the number of participants reporting at least one blood pressure (BP) measurement within the first 10 days postpartum. Secondary outcomes included total number of BP measurements reported through the program, HTN-related Emergency Department (ED) visit or readmission, initiation of antihypertensive medication, and severe maternal morbidity (SMM). Relative risks were calculated after adjusting for confounders.

Results:

Among 2556 patients enrolled in the SMBP, 27.7% had infants admitted to the NICU. Compared to those with infants in the nursery, those with infants in the NICU delivered at earlier gestational ages and were more likely to have severe preeclampsia, superimposed preeclampsia, and require ICU admission after delivery. After adjusting for these factors, there was no significant difference in the primary outcome of participants reporting a BP measurement within 10 days postpartum (aRR 0.99, 95% CI 0.89 -1.10). There were no significant differences in secondary outcomes including HTN-related ED visits, readmissions, or SMM.

Conclusion:
These findings suggest that even though those with infants in the NICU have more severe presentations of HDP and other competing priorities in the postpartum period, SMBP engagement is similar and may mitigate postpartum hypertension-related morbidity in this population.