# USPSTF evidence review: screening op hypertensieve zwangerschapsstoornissen

*geplaatst 2023-09-19 · Hypertensie · JAMA · doi 10.1001/jama.2023.4934 · https://hartvaat.nl/2023/09/19/uspstf-evidence-review-screening-op-hypertensieve-zwangerschapsstoornissen/*

Systematische review ondersteunde bloeddrukscreening tijdens de zwangerschap als effectieve methode om pre-eclampsie en gerelateerde complicaties te detecteren. Vroege diagnose maakt tijdige interventie mogelijk.

## English: Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

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.

## Abstract (original, from the publication)

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.

Auteurs: Jillian T Henderson, Elizabeth M Webber, Rachel G Thomas, Kimberly K Vesco

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Bron: JAMA, https://doi.org/10.1001/jama.2023.4934. Bijgewerkt 2026-07-03T18:39:06Z. 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.