Does History of Prematurity Prompt Blood Pressure Evaluations at Primary Care Visits?

Area of Science:

• Pediatrics
• Cardiology
• Public Health

Background:

• Prematurity is a significant risk factor for developing elevated blood pressure (BP).
• Early identification of hypertension in infants born prematurely (IBP) is crucial for long-term cardiovascular health.
• Current screening practices and provider awareness of recommendations for IBP require investigation.

Purpose of the Study:

• To assess care patterns and provider awareness regarding early blood pressure (BP) screening recommendations for infants born prematurely (IBP).
• To evaluate the documentation of BP screening in medical records of IBP.
• To identify factors associated with BP screening in this high-risk population.

Main Methods:

• A mixed-methods approach combining provider interviews/surveys and retrospective medical record review.
• Interviews/surveys assessed practice- and provider-level BP screening protocols and guideline awareness.
• Infant records were analyzed for BP documentation, demographics, gestational age (GA), and comorbidities.

Main Results:

• Only 4% of practices had a BP measurement protocol for IBP, though 81% had equipment.
• Awareness of screening guidelines was low among providers (28% of 86), with none reporting routine assessment.
• BP was documented in only 28% of 118 IBP, with 43% showing BP ≥90th percentile.
• Kidney-related diagnoses were linked to more frequent BP screening (P = .0454).

Conclusions:

• Blood pressure is not routinely measured in infants born prematurely, despite a high prevalence of elevated BP before age three.
• Gaps exist in provider awareness and implementation of early BP screening guidelines for IBP.
• Targeted interventions are needed to improve BP monitoring and management in this vulnerable population.