Global Blood Pressure Screening During and After Pregnancy: May Measurement Month 2019.

Abstract

Background: Hypertensive disorders of pregnancy are associated with high maternal and fetal morbidity and mortality. There are limited global data on the characteristics of women during and after pregnancy hypertension.

Methods: May Measurement Month is a global campaign to raise awareness of the importance of blood pressure. Adults (≥18 years) recruited through opportunistic sampling during May 2019 had blood pressure measured and comorbidities and lifestyle data collected. This secondary analysis included 16 519 pregnant women and 529 172 nonpregnant women (16 457 with previous raised blood pressure in pregnancy) from 64 countries.

Results: Almost half of the pregnant women (43.3%) reported not having had their blood pressure measured in the past year, and 14.3% (95% CI, 12.1-16.6) had hypertension (blood pressure ≥140/90 mm Hg or taking antihypertensive medication). Diabetes was self-reported in 7.6% (5.9-9.3) of pregnant women with hypertension and 2.8% (1.9-3.6) of pregnant women without hypertension. In nonpregnant women with and without a history of pregnancy hypertension, age-standardized proportions with current hypertension were 53.2% (50.8-55.7) versus 33.3% (29.3-37.3); with diabetes were 14.4% (11.8-17.0) versus 8.5% (6.3-10.9); and with body mass index ≥30 kg/m² were 28.4% (23.5-33.3) versus 16.6% (13.0-20.2).

Conclusions: Hypertension in pregnancy was common in this global sample but many cases had not previously been identified. There was a clustering of cardiovascular risk factors in both pregnant women with current hypertension and previously raised blood pressure in pregnancy. This work highlights the importance of screening pregnant women for hypertension, which remains a challenge in large parts of the world.