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Pregnancy and Postpartum Trends in Self-Measured Blood Pressure and Derived Indices: The BOSHI Study

Seiya Izumi1,2, Misato Nishimura2, Noriyuki Iwama1,3

  • 1Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Journal of Clinical Hypertension (Greenwich, Conn.)
|January 17, 2025
PubMed

Insights

This study tracked self-measured blood pressure (SMBP) and related metrics in pregnant and postpartum individuals. Blood pressure generally increased postpartum, while pulse rate and shock index showed distinct trends around delivery.

Area of Science:

  • Cardiovascular health
  • Maternal-fetal medicine
  • Longitudinal cohort studies

Background:

  • Self-measured blood pressure (SMBP) monitoring is crucial for managing hypertension during and after pregnancy.
  • Understanding trends in blood pressure and related cardiovascular indices postpartum is essential for maternal health.

Purpose of the Study:

  • To investigate trends in SMBP and derived indices during pregnancy and the postpartum period.
  • To analyze changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), Shock Index, and double product.

Main Methods:

  • Prospective cohort study (BOSHI Study) in Japan.
  • 237 normotensive participants measured SMBP daily during pregnancy and for 1 month postpartum.
  • Mixed-effects models for repeated measures were used for analysis.

Main Results:

  • SBP and DBP increased postpartum, peaking around postpartum days 7-8.
  • PR showed an inverted U-shape during pregnancy, then increased sharply postpartum.
  • Shock Index and double product exhibited specific trends related to labor and the early postpartum period.

Conclusions:

  • Significant postpartum BP elevation occurs even in normotensive individuals.
  • Cardiovascular indices like PR and Shock Index display dynamic changes around delivery and postpartum.
  • SMBP monitoring provides valuable insights into maternal cardiovascular adaptation.

Keywords:
blood pressure self‐monitoringcohort studiespostpartum periodpregnancypulse rate

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