Self-monitoring of blood pressure has become increasingly common among pregnant women in recent years, particularly since the onset of the Covid-19 pandemic which led to a reduction in face-to-face antenatal appointments. However, until recently, there was very little evidence of the use of blood pressure self-monitoring during pregnancy. Two newly published studies, the BUMP 1 and 2 trials have made a significant contribution to this knowledge gap.
Led by a team of researchers at the University of Oxford, the purpose of these linked trials was to see whether blood pressure self-monitoring could lead to earlier detection of high blood pressure in pregnancy (BUMP 1) and the effect self-monitoring might have on blood pressure control and related outcomes among pregnant women with raised blood pressure (BUMP 2).
The women who took part in the trials were randomly allocated to either carry on with their normal antenatal care, or to monitor their blood pressure at home in addition to their usual care – either three time a week (BUMP 1) or daily (BUMP 2). The self-monitoring group were asked to submit their readings using an App designed for the study. The App would provide instant feedback on whether the blood pressure entered was normal or high and instructions on what to do if it went above or bellow certain thresholds.
The researchers found that while self-monitoring appeared to be safe, it made no difference to the timing of diagnosis or control of high blood-pressure. Interestingly though, over half of the women in the self-monitoring group of BUMP 1 had raised blood pressure at home – around one month prior to their clinic diagnosis. This suggests that home monitoring could lead to earlier diagnosis, but further work is needed to understand how.
Altogether over 2400 women took part in the trials across fifteen hospitals throughout England, making this the largest completed investigation into pregnancy-related blood-pressure self-monitoring to date. The results provide important insight into the potential benefits of blood-pressure self-monitoring in pregnancy, the next step is to investigate how women’s home readings could be integrated into and support improvements in routine antenatal care.
From APEC’s perspective this is hugely exciting news – we firmly believe in women being empowered to take ownership of their health and knowing that home monitoring can identify rising blood pressure earlier is very important.