Abstract：
OBJECTIVE: In the immediate postpartum period, mothers often prioritize newborn care over postpartum follow-up. There is an increasing contribution of hypertensive disorders of pregnancy (HDP) to maternal morbidity and mortality. In this feasibility study, we sought to implement maternal postpartum blood pressure (BP) screening in a newborn clinic.
METHODS: We conducted a non-randomized, prospective feasibility study to evaluate the application of maternal BP screening at newborn clinic visits. An elevated BP was defined as a systolic pressure (SBP) of ≥140 mmHg or a diastolic pressure (DBP) of ≥90 mmHg. BPs were triaged with a standardized algorithm, utilizing support and expertise of on-call maternal subspecialists.
RESULTS: We screened 72 postpartum individuals, with a mean SBP of 130±19 mmHg and DBP 86±12 mmHg. Most were publicly insured (78%) and self-identified as Black (69%). Of the 31 (43%) with an elevated BP, 13 (42%) did not have a known HDP. Of those without known HDP, 4 were diagnosed with postpartum preeclampsia and 2 with postpartum hypertension. One individual diagnosed with new-onset postpartum preeclampsia was triaged to the emergency department. Only 56% of women attended a obstetrics appointment within 12 weeks after delivery.
CONCLUSIONS: This study demonstrates the feasibility of an innovative maternal postpartum BP assessment in a racially and socioeconomically diverse pediatrics clinic. Through collaborative care, individuals were able to be safely triaged, thus providing an opportunity to identify at-risk individuals who could benefit from earlier identification and management of hypertension. Pediatricians have a unique opportunity to contribute to postpartum maternal health.
METHODS: We conducted a non-randomized, prospective feasibility study to evaluate the application of maternal BP screening at newborn clinic visits. An elevated BP was defined as a systolic pressure (SBP) of ≥140 mmHg or a diastolic pressure (DBP) of ≥90 mmHg. BPs were triaged with a standardized algorithm, utilizing support and expertise of on-call maternal subspecialists.
RESULTS: We screened 72 postpartum individuals, with a mean SBP of 130±19 mmHg and DBP 86±12 mmHg. Most were publicly insured (78%) and self-identified as Black (69%). Of the 31 (43%) with an elevated BP, 13 (42%) did not have a known HDP. Of those without known HDP, 4 were diagnosed with postpartum preeclampsia and 2 with postpartum hypertension. One individual diagnosed with new-onset postpartum preeclampsia was triaged to the emergency department. Only 56% of women attended a obstetrics appointment within 12 weeks after delivery.
CONCLUSIONS: This study demonstrates the feasibility of an innovative maternal postpartum BP assessment in a racially and socioeconomically diverse pediatrics clinic. Through collaborative care, individuals were able to be safely triaged, thus providing an opportunity to identify at-risk individuals who could benefit from earlier identification and management of hypertension. Pediatricians have a unique opportunity to contribute to postpartum maternal health.
摘要：
目标：产后即刻，母亲通常优先考虑新生儿护理而不是产后随访。妊娠高血压疾病（HDP）对孕产妇发病率和死亡率的影响越来越大。在这个可行性研究中,我们试图在新生儿诊所实施产妇产后血压(BP)筛查.
方法：我们进行了非随机，前瞻性可行性研究，以评估孕妇BP筛查在新生儿门诊就诊中的应用。BP升高定义为收缩压（SBP）≥140mmHg或舒张压（DBP）≥90mmHg。BP用标准化算法进行分类，利用待命产妇专家的支持和专业知识。
结果：我们筛选了72名产后个体，平均SBP为130±19mmHg，DBP为86±12mmHg。大多数人是公共保险（78％）和自我识别为黑人（69％）。在血压升高的31人(43%)中，13（42%）没有已知的HDP。在那些没有已知HDP的人中，4例诊断为产后子痫前期，2例诊断为产后高血压。一名被诊断为新发产后先兆子痫的患者被送往急诊科。只有56％的妇女在分娩后12周内参加了产科预约。
结论：这项研究证明了在种族和社会经济多样化的儿科诊所中进行创新的产妇产后血压评估的可行性。通过合作关怀,个人能够被安全地分类，从而提供了一个机会来识别可能从早期高血压的识别和管理中获益的高危个体.儿科医生有一个独特的机会来促进产后产妇健康。
方法：我们进行了非随机，前瞻性可行性研究，以评估孕妇BP筛查在新生儿门诊就诊中的应用。BP升高定义为收缩压（SBP）≥140mmHg或舒张压（DBP）≥90mmHg。BP用标准化算法进行分类，利用待命产妇专家的支持和专业知识。
结果：我们筛选了72名产后个体，平均SBP为130±19mmHg，DBP为86±12mmHg。大多数人是公共保险（78％）和自我识别为黑人（69％）。在血压升高的31人(43%)中，13（42%）没有已知的HDP。在那些没有已知HDP的人中，4例诊断为产后子痫前期，2例诊断为产后高血压。一名被诊断为新发产后先兆子痫的患者被送往急诊科。只有56％的妇女在分娩后12周内参加了产科预约。
结论：这项研究证明了在种族和社会经济多样化的儿科诊所中进行创新的产妇产后血压评估的可行性。通过合作关怀,个人能够被安全地分类，从而提供了一个机会来识别可能从早期高血压的识别和管理中获益的高危个体.儿科医生有一个独特的机会来促进产后产妇健康。
