{"id":"9f7f40ff69ff","type":"article","url":"https://hartvaat.nl/2023/09/19/uspstf-evidence-review-screening-op-hypertensieve-zwangerschapsstoornissen/","title":"USPSTF evidence review: screening op hypertensieve zwangerschapsstoornissen","title_en":"Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.","category":"hypertensie","category_label":"Hypertensie","professions":["huisarts"],"tags":["bloeddrukbehandeling","primaire-preventie","summit-trial","zwangerschap-hart"],"journal":"JAMA","doi":"10.1001/jama.2023.4934","source_url":"https://doi.org/10.1001/jama.2023.4934","authors":["Jillian T Henderson","Elizabeth M Webber","Rachel G Thomas","Kimberly K Vesco"],"significance":6,"published":"2023-09-19","source_date":"2023-09-19","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/bloeddrukmeting-thuismeting-abpm/"],"congress":"","summary_en":"This USPSTF systematic review supported blood pressure screening throughout pregnancy as an effective method for detecting preeclampsia and related disorders, confirming the maternal and fetal benefits of early detection.","created":"2026-07-03T10:30:34Z","updated":"2026-07-03T18:39:06Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Systematische review ondersteunde bloeddrukscreening tijdens de zwangerschap als effectieve methode om pre-eclampsie en gerelateerde complicaties te detecteren. Vroege diagnose maakt tijdige interventie mogelijk.","abstract_original":"IMPORTANCE: Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality in the US. OBJECTIVE: To conduct a targeted systematic review to update the evidence on the effectiveness of screening for hypertensive disorders of pregnancy to inform the US Preventive Services Task Force. DATA SOURCES: MEDLINE and the Cochrane Central Register of Controlled Trials for relevant studies published between January 1, 2014, and January 4, 2022; surveillance through February 21, 2023. STUDY SELECTION: English-language comparative effectiveness studies comparing screening strategies in pregnant or postpartum individuals. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently appraised articles and extracted relevant data from fair-or good-quality studies; no quantitative synthesis was conducted. MAIN OUTCOMES AND MEASURES: Morbidity or mortality, measures of health-related quality of life. RESULTS: The review included 6 fair-quality studies (5 trials and 1 nonrandomized study; N = 10 165) comparing changes in prenatal screening practices with usual care, which was routine screening at in-person office visits. No studies addressed screening for new-onset hypertensive disorders of pregnancy in the postpartum period. One trial (n = 2521) evaluated home blood pressure measurement as a supplement to usual care; 3 trials (total n = 5203) evaluated reduced prenatal visit schedules. One study (n = 2441) evaluated proteinuria screening conducted only for specific clinical indications, compared with a historical control group that received routine proteinuria screening. One additional trial (n = 80) only addressed the comparative harms of home blood pressure measurement. The studies did not report statistically significant differences in maternal and infant complications with alternate strategies compared with usual care; however, estimates were imprecise for serious, rare health outcomes. Home blood pressure measurement added to prenatal care visits was not associated with earlier diagnosis of a hypertensive disorder of pregnancy (104.3 vs 106.2 days), and incidence was not different between groups in 3 trials of reduced prenatal visit schedules. No harms of the different screening strategies were identified. CONCLUSIONS AND RELEVANCE: This review did not identify evidence that any alternative screening strategies for hypertensive disorders of pregnancy were more effective than routine blood pressure measurement at in-person prenatal visits. Morbidity and mortality from hypertensive disorders of pregnancy can be prevented, yet American Indian/Alaska Native persons and Black persons experience inequitable rates of adverse outcomes. Further research is needed to identify screening approaches that may lead to improved disease detection and health outcomes."}