At-home blood pressure monitoring for pregnant patients at high-risk for preeclampsia may be as safe and effective as clinic visits according to new research published in American Journal of Obstetrics and Gynecology. 

In a study of 270 patients (mean age, about 34 years; 40% White) followed up to 6 weeks post-partum at three hospitals in Australia, those who reported their blood pressure measurements from home and those who received usual care had similar rates of adverse neonatal outcomes. About 1 in 4 in each group experienced perinatal loss, prolonged neonatal intensive care, or having a small-for-gestational age baby.

Maternal outcomes — including rates of preeclampsia, stroke, placental abruption, cesarean delivery, and induction — were similar between groups.

Based on the findings, the researchers plan to implement the new approach with their pregnant patients, said Theepika Rajkumar, MBBS, MSc, a nephrologist and obstetric physician at South Western Sydney Local Health District - Liverpool and Campbelltown Hospitals in Australia, and lead author of the study. 

The study adds to earlier research pointing to the efficacy of remote monitoring. 

“The structure of high-risk antenatal care will vary across different healthcare systems and this needs to be considered; however, we feel there is definitely a role for remote blood pressure monitoring for extra surveillance instead of in-person visits,” Rajkumar said. 

“Having a way to identify high blood pressure sooner rather than later makes a lot of sense clinically,” said Swati Shree, MD, an associate professor of maternal fetal medicine at University of Washington in Seattle, who was not associated with the study. 

The study took place between 2022 and 2024. Patients in the usual care group attended in-person visits as needed, while those in the remote group checked their blood pressure at home three times per week using a validated device, with readings automatically transmitted to clinicians through an app that flagged concerning values and triggered follow-up. 

The structured monitoring approach was likely key to the intervention’s success, Rajkumar said. Systems need to avoid overwhelming clinicians by flagging only readings that require attention, while also giving patients clear, actionable guidance when results fall outside the expected range. 

Patients in the remote group had fewer total antenatal visits (median, 14 vs 16) and fewer planned outpatient appointments (10 vs 13). They were less likely to be hospitalized overall (hazard ratio [HR], 0.54) or for hypertension specifically (HR, 0.41), with no increase in unplanned hospital visits. 

Participants in the remote monitoring group filled more antihypertensive prescriptions than those receiving usual care (median five vs three prescriptions per patient), likely because clinicians could adjust treatment quickly based on incoming readings, instead of waiting for scheduled clinic visits to make changes, Rajkumar said. 

Given the similar outcomes for both groups, the increased medication use in the remote group was reassuring to Shree. “There’s always this question of whether or not we are harming the infant or fetus through medication,” Shree said. 

The approach may not be suitable for patients with limited digital literacy or language barriers, but would otherwise be broadly applicable, giving clinicians more data points and a clearer picture of patients’ blood pressure in their home environment, Shree said. 

The sources cited in this article report no disclosures. The study was funded by the investigators and a grant from Society of Obstetric Medicine in Australia and New Zealand.

Brittany Vargas is a journalist covering medicine, mental health, and wellness.

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