Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy
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Le résumé fourni par la source
Importance: Inadequate management of elevated blood pressure (BP) is a significant contributing factor to maternal deaths. Self-monitoring of BP in the general population has been shown to improve the diagnosis and management of hypertension; however, little is known about its use in pregnancy. Objective: To determine whether self-monitoring of BP in higher-risk pregnancies leads to earlier detection of pregnancy hypertension. Design, Setting, and Participants: Unblinded, randomized clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. Final follow-up was completed in April 2020. Interventions: Participating individuals were randomized to either BP self-monitoring with telemonitoring (n = 1223) plus usual care or usual antenatal care alone (n = 1218) without access to telemonitored BP. Main Outcomes and Measures: The primary outcome was time to first recorded hypertension measured by a health care professional. Results: Among 2441 participants who were randomized (mean [SD] age, 33 [5.6] years; mean gestation, 20 [1.6] weeks), 2346 (96%) completed the trial. The time from randomization to clinic recording of hypertension was not significantly different between individuals in the self-monitoring group (mean [SD], 104.3 [32.6] days) vs in the usual care group (mean [SD], 106.2 [32.0] days) (mean difference, -1.6 days [95% CI, -8.1 to 4.9]; P = .64). Eighteen serious adverse events were reported during the trial with none judged as related to the intervention (12 [1%] in the self-monitoring group vs 6 [0.5%] in the usual care group). Conclusions and Relevance: Among pregnant individuals at higher risk of preeclampsia, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly earlier clinic-based detection of hypertension. Trial Registration: ClinicalTrials.gov Identifier: NCT03334149.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy
- Date Crossref
- 03/05/2022
- Éditeur
- American Medical Association (AMA)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Oxford Nuffield Department of Primary Care Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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St Thomas' Hospital pays non établi dans la noticeÉtablissement de santé
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King's College London Department of Women and Children’s Health pays non établi dans la noticeUniversité ou école supérieure
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University of Southampton Department of Psychology pays non établi dans la noticeUniversité ou école supérieure
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The Stables pays non établi dans la noticeInstitution
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University of Birmingham Institute of Applied Health Research pays non établi dans la noticeUniversité ou école supérieure
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University of Cambridge The Healthcare Improvement Studies Institute pays non établi dans la noticeUniversité ou école supérieure
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University of London City pays non établi dans la noticeUniversité ou école supérieure
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University of Bristol pays non établi dans la noticeUniversité ou école supérieure
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Action on Pre-eclampsia pays non établi dans la noticeInstitution
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School of Psychological Science pays non établi dans la noticeUniversité ou école supérieure
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for the BUMP Investigators pays non établi dans la noticeInstitution
Nuffield Department of Primary Care Health Sciences — University of Oxford, St Thomas' Hospital et Department of Women and Children’s Health — King's College London, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.