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Multicenter Study
. 2020 Oct:22:30-36.
doi: 10.1016/j.preghy.2020.07.006. Epub 2020 Jul 18.

SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia - A case-control study

Josephus F M van den Heuvel  1 , A Titia Lely  2 , Jolijn J Huisman  3 , Jaap C A Trappenburg  4 , Arie Franx  5 , Mireille N Bekker  6
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Free article
Multicenter Study

SAFE@HOME: Digital health platform facilitating a new care path for women at increased risk of preeclampsia - A case-control study

Josephus F M van den Heuvel et al. Pregnancy Hypertens. 2020 Oct.
Free article

Abstract

Objective: In women at risk of developing preeclampsia, we evaluated the use of a digital health platform for telemonitoring blood pressure and symptoms combined with a minimal antenatal visit schedule.

Study design: A case-control study for women with chronic hypertension, history of preeclampsia, or maternal cardiac or kidney disease. A care path was designed with reduced visits enhanced with a digital platform (SAFE@HOME) for daily blood pressure and symptom monitoring starting from 16 weeks of gestation. Home-measurements were monitored in-hospital by obstetric professionals, taking actions upon alarming results. This prospective SAFE@HOME group was compared to a retrospective control group managed without self-monitoring.

Main outcome measures: Primary: healthcare consumption (number of antenatal visits, ultrasounds, admissions and diagnostics), user experiences of the platform. Secondary: maternal and perinatal outcomes.

Results: Baseline characteristics of the SAFE@HOME (n = 103) and control group (n = 133) were comparable. In the SAFE@HOME group, antenatal visits (mean 13.7 vs 16.0, p < 0.001) and ultrasounds (6.3 vs 7.4, p = 0.005) were lower compared to the control group. Admissions for hypertension or suspected preeclampsia were significantly fewer in the SAFE@HOME group (2.9% versus 13.5%, p = 0.004). Telemonitoring participants were highly satisfied using the platform. No differences were observed for maternal and perinatal outcomes.

Conclusions: Our care path including blood pressure telemonitoring for women at risk of preeclampsia allows fewer antenatal visits, ultrasounds and hypertension-related admissions. We observed no differences in perinatal outcomes. These results suggest that telemonitoring of blood pressure is feasible in a high-risk pregnant population and has the potential to profoundly change antenatal care.

Keywords: Blood pressure; Digital health; Preeclampsia; Telemedicine; Telemonitoring; eHealth.

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