LEANBH (Learning to Evaluate and manage ANtenatal Blood pressure at Home) is a prospective, observational, non-interventional cohort, pilot study of a novel connected health solution aimed at empowering women to self-manage blood pressure (BP) monitoring in pregnancy. Hypertension in pregnancy affects around 5–8% of all pregnancies and misdiagnosis or poorly managed BP in pregnancy negatively affects maternal and neonatal outcomes.
The primary objective of this study was to assess the feasibility and acceptability of home blood pressure monitoring (HBPM) and to compare these BP readings taken at home using the LEANBH architecture to those taken in healthcare settings (hospital and general practice).
Patients, materials and methods
Healthy primigravida with low risk singleton pregnancies were recruited from Cork University Maternity Hospital, Ireland. Women were equipped with a Microlife WatchBP Home Monitor, an Urisys 1100® Urine Analyzer and the mobile app developed for use throughout pregnancy as part of the Leanbh project. Participants were encouraged to submit BP and urine readings from home as frequently as possible and especially prior to an antenatal visit. All women attended their planned healthcare visits as usual. Mean arterial pressure (MAP) was calculated from the BP readings uploaded to a LEANBH platform throughout pregnancy and analysed using SPSS version 2.0 Mann–Whitney test.
51 women volunteered with 46 of them completing the study. 27 women were equipped with the devices with 5 subsequently withdrawing from this group while 24 women were recruited into the control group.
A total of 1381 home BP readings and 983 healthcare setting BP readings were recorded with 972 paired (home vs healthcare setting) MAP available for analysis. The Mann–Whitney test performed showed statistical significance between the home vs healthcare setting MAP with a P value <0.05.
A user error rate of 3.8% was noted among the HBPM group.
BP taken at home was significantly lower than that taken in a health care setting, suggesting that the incidence of white coat hypertension in this cohort is under reported. The low error rate suggests that HPBM is easy to use. A large randomized control trial is planned to fully evaluate the utility of this technology solution.