Does History of Prematurity Prompt Blood Pressure Evaluations at Primary Care Visits?

Kornfeld, Benjamin; Finer, Gal; Banks, Laura; Bolaños, Liliana; Ariza, Adolfo J.

doi:10.1177/2333794x19828314

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Our results showed that a history of hypertension is a risk factor for preterm birth. This result is also seen in the study by Kornfeld et al (2019) [35]. Also, the study by Jones et al (2019) [36] showed that pregnant mothers at a younger age who have uncontrolled blood pressure have a higher risk of preterm birth.…”

Section: Discussionsupporting

confidence: 65%

Exploring the prognostic significance of β-HCG levels in cervicovaginal secretions and maternal risk factors for early birth

Homood Alharbi,

Abdualrahman Saeed Alshehry,

Ahmed Alsadoun

et al. 2024

Cell Mol Biol (Noisy-le-grand)

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Preterm birth is one of the leading causes of death in the perinatal period, this study was conducted to investigate the predictive value of β-HCG levels in cervicovaginal secretions and maternal risk factors in preterm delivery. This cross-sectional study was conducted over a six-month period from January 1 to June 30, 2021, in Baghdad hospitals. The data were collected and used from the mothers who went to the hospital for delivery. Demographic information of patients and some risk factors were investigated. Vaginal secretions were sampled with a cotton swab. β-HCG level in weeks 29, 31, 33, and 35 was measured by ELISA method. Data were analyzed with SPSS Ver 25 software and a significance level of less than 0.05 was considered. The mean age of the study participants was 28.29 ± 5.68 years. There was a significant difference in the level of β-HCG between women with full-term delivery and pre-term women in weeks 29, 31, 33, and 35 of pregnancy (P ≤ 0.001). Maternal factors such as age older than 35 years, BMI, history of thyroid disease, blood pressure, premature rupture of the amniotic sac, parity, twin and multiple births, and decreased amniotic fluid volume have been identified as factors affecting preterm delivery. The β-HCG level can also be a helpful marker for preterm birth.

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Section: Discussionsupporting

confidence: 65%

Exploring the prognostic significance of β-HCG levels in cervicovaginal secretions and maternal risk factors for early birth

Homood Alharbi,

Abdualrahman Saeed Alshehry,

Ahmed Alsadoun

et al. 2024

Cell Mol Biol (Noisy-le-grand)

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“…[ 46 , 47 ] Despite these recommendations, pediatricians do not frequently examine BP in preterm children under the age of three. [ 48 ] By utilizing this information and the findings of our meta-analysis, primary care physicians can play a critical role in minimizing the long-term effects of high BP in preterm-born individuals by adopting heightened vigilance in monitoring BP and implementing appropriate therapies. Finally, the collaboration of primary care physicians and pediatric specialists is critical in managing these high-risk individuals and delivering a thorough multidisciplinary approach.…”

Section: Discussionmentioning

confidence: 99%

Effect of preterm birth on blood pressure in later life: A systematic review and meta-analysis

Alsubai,

Ahmad,

Chang

et al. 2023

Journal of Family Medicine and Primary Care

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Introduction: Preterm birth is linked to various complications in both infancy and adulthood. We assessed the association between preterm birth and hypertension in adulthood. Materials and Methods: PubMed, EMBASE, and Cochrane CENTRAL Register were searched for randomized controlled trials (RCT) comparing systolic and diastolic blood pressures in individuals born preterm and those born full-term, from inception till April 11th, 2022. Data were extracted, pooled, and analyzed. Forest plots were created for a visual demonstration. Results: Twenty-eight studies were included in our meta-analysis. SBP and DBP across all categories (Mean, Ambulatory, Daytime, and Nighttime) were higher in the preterm group compared to the term group. Mean SBP, mean ambulatory SBP, mean daytime SBP and mean nighttime SBP were 4.26 mmHg [95% CI: 3.09–5.43; P < 0.00001], 4.53 mmHg [95% CI: 1.82–7.24; P = 0.001], 4.51 mmHg [95% CI: 2.56–6.74; P < 0.00001], and 3.06 mmHg [95% CI: 1.32–4.80; P = 0.0006] higher in the preterm group, respectively. Mean DBP, mean ambulatory DBP, mean daytime DBP, and mean nighttime DBP were 2.32 mmHg [95% CI: 1.35–3.29; P < 0.00001], 1.54 mmHg [95% CI 0.68–2.39; P = 0.0004], 1.74 mmHg [95% CI: 0.92–2.56; P < 0.0001], and 1.58 mmHg [95% CI: 0.34–2.81; P = 0.01] higher in the preterm group, respectively. Conclusion: Our observations suggest that individuals who were born preterm may have higher blood pressures as compared to those who were born full-term.

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“…This rate is similar to the low rates of blood pressure screening in patients less than 3 years of age with risk factors for hypertension documented in prior studies. 8 , 13 A mixed-methods study of a pediatric practice-based research network found that blood pressure was only documented in 14% of health care visits in children younger than 3 years of age with a history of prematurity. 13 Reasons for low adherence rates to the AAP blood pressure screening guidelines are postulated to include provider time constraints and lack of a standardized protocol for measuring blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Improving Blood Pressure Screening in Neonatal Follow-up Clinic: A Quality Improvement Initiative

Flynn

Zedalis

Bernbaum

et al. 2022

Pediatric Quality &Amp; Safety

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Introduction: The American Academy of Pediatrics recommends blood pressure screening at every health care encounter in children younger than 3 years if they have a history of prematurity or other neonatal complications requiring intensive care because these children have an increased risk for hypertension. Methods: A multidisciplinary team conducted a quality improvement initiative to improve blood pressure screening at a single-center outpatient neonatal follow-up clinic. We developed a focused intervention program including a standardized blood pressure measurement protocol, staff training and education, and streamlined documentation. We conducted two Plan-Do-Study-Act cycles from November 2019 to January 2021. The outcome measure was the percentage of patients with a blood pressure measurement. Process measures included the percentage of medical assistants educated on the new protocol, percentage of patients 3 years, and younger old with the first blood pressure measurement taken from the right arm, and the percentage of patients 1 year and younger with 3 documented blood pressures. The balancing measure was staff satisfaction with time to obtain vital signs. We used statistical process control charts and Wilcoxon rank-sum test. Results: At baseline, only 15.3% of patients had documented blood pressure. During the 10-month intervention period, there were 954 patient visits. Overall, blood pressure measurement increased to 54.7% with study interventions. The balancing measure was not negatively impacted. Conclusions: After implementing a program of focused interventions, we substantially improved the frequency of blood pressure measurements and increased adherence to American Academy of Pediatrics screening guidelines. Improved blood pressure screening allows us to identify and evaluate at-risk infants after hospital discharge.

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Does History of Prematurity Prompt Blood Pressure Evaluations at Primary Care Visits?

Cited by 4 publications

References 21 publications

Exploring the prognostic significance of β-HCG levels in cervicovaginal secretions and maternal risk factors for early birth

Exploring the prognostic significance of β-HCG levels in cervicovaginal secretions and maternal risk factors for early birth

Effect of preterm birth on blood pressure in later life: A systematic review and meta-analysis

Improving Blood Pressure Screening in Neonatal Follow-up Clinic: A Quality Improvement Initiative

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