Doctors should screen pregnant people for high blood pressure regularly, task force says

Adrianna Rodriguez, USA TODAY
·3 min read
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Doctors should measure blood pressure frequently throughout a person's pregnancy to screen for hypertensive disorders regardless of symptoms, according to draft guidelines from the U.S. Preventive Services Task Force.

Hypertension, or high blood pressure, is “very common” during pregnancy, according to the Centers for Disease Control and Prevention. It's also on the rise: Research shows rates of high blood pressure during pregnancy have doubled in the past 12 years.

The new guidance reinforces existing recommendations from 2017, and health experts hope it reaches pregnant people who are not receiving prenatal care, or using telehealth without measuring blood pressure.

High blood pressure during pregnancy can be fatal. More than 30% of pregnant people from 2017 to 2019 who died during delivery had a documented hypertensive disorder, and nearly 25% had pregnancy-associated high blood pressure, according to a CDC report last year.

"Early access to prenatal care and adequate prenatal visit improves health outcomes," said Dr. Tosin Goje, director of the Cleveland Clinic's Center for Maternal and Infant Health. "During prenatal care in the first trimester, you have proper dating of the pregnancy (and) you can pinpoint risk factors that may influence or impact pregnancy outcome."

The public is able to comment on the draft guidelines until March 6. To read the guidelines, click here.

Health disparities and high blood pressure

Health experts say the update is an opportunity to spread awareness about health disparities. A 2022 CDC report found hypertensive disorders in pregnancy were more prevalent in Black and American Indian and Alaska Native women compared with other races and ethnicities.

"Evidence shows there's a lot of racial disparities when it comes to the morbidity and mortality associated with hypertensive disorders during pregnancy," Goje said. "By bringing this discussion back, we're able to talk about the evidence that there’s a disparity but also to look for solutions."

Mapping out disparities: Maternal mortality rates are higher for rural women of color

Complications from high blood pressure in pregnancy

According to the CDC, complications of high blood pressure during pregnancy include:

  • Preeclampsia.

  • Eclampsia.

  • Stroke.

  • Labor induction, or giving medicine to start labor and give birth.

  • Placental abruption.

High blood pressure also makes it more difficult to get enough oxygen and nutrients to the baby and can lead to:

  • Preterm delivery.

  • Low birth weight.

Symptoms of high blood pressure and preeclampsia

Pregnant people don't typically experience symptoms from high blood pressure, health experts say. But high blood pressure could lead to preeclampsia, a condition that develops midway through pregnancy, typically around 20 weeks, according to the Cleveland Clinic.

People with preeclampsia have high blood pressure and high levels of protein in their urine.

"Preeclampsia increases the risk of death or handicap for both the pregnant person and their offspring," said Dr. Janice Henderson, director of the Fetal Assessment Center and Assistant Professor of Gynecology and Obstetrics at Johns Hopkins Medicine. "The earlier preeclampsia occurs (in pregnancy), the greater the risk."

The CDC says signs of preeclampsia may include:

  • Headache.

  • Changes in vision such as blurry vision, seeing spots, or having changes in eyesight.

  • Pain in the upper stomach area.

  • Nausea or vomiting.

  • Swelling of the face or hands.

  • Sudden weight gain.

  • Trouble breathing.

What causes high blood pressure during pregnancy?

It's unclear why some pregnant people develop high blood pressure, but health experts say changes that occur during pregnancy may contribute.

"When it comes to pregnancy, there are still many things that are unknown," Goje said. "They have more blood volume, they have hormonal changes. ... But not every pregnant patient develops hypertensive disorder during pregnancy."

According to the Mayo Clinic, some risk factors linked to high blood pressure include:

  • Age: The risk of high blood pressure increases with age.

  • Race: High blood pressure is particularly common among Black people compared with white people.

  • Family history: A patient is more likely to develop high blood pressure if a parent or sibling has the condition.

  • Obesity or being overweight.

  • Lack of exercise.

  • Tobacco use or vaping.

  • Excess salt.

  • Too much alcohol.

  • High levels of stress.

  • Other health problems: Kidney disease, diabetes and sleep apnea, among others.

Dig deeper: More health news

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: Blood pressure should be regularly monitored during pregnancy