Tracking Engagement with Remote Patient Monitoring in Prenatal Care and Detection of Preeclampsia: A Retrospective...

Introduction: Mobile technology may enhance traditional prenatal care by supporting screening and patient compliance. Although prior studies report high satisfaction with mobile prenatal technologies, the impact of integrating remote patient monitoring (RPM) into routine workflows on clinical outcomes remains uncertain. This retrospective study assessed whether higher engagement with RPM via the Babyscripts™ digital health platform was associated with increased detection of preeclampsia (PEC). Methods: In this university-based obstetric practice, pregnant patients received the Babyscripts™ platform in addition to standard care. The platform enabled tracking of gestational weight gain and blood pressure and delivered scheduled education on symptoms and screening tests. Patients were included if they initiated RPM use before the end of the first trimester; those without available pregnancy outcomes were excluded. Chart reviews were performed using structured data forms by trained abstractors. RPM engagement was defined as the percentage of weeks with at least one remote blood pressure measurement. Outcomes included PEC and a composite of maternal complications. Multivariate logistic regression identified predictors of engagement. Results: A total of 823 patients were included: 28% identified as Black, 32% were Medicaid/Medicare recipients, 43% were over age 35, and 5% had a history of hypertension. Thirty-seven patients developed PEC or pregnancy-induced hypertension. Living in a distressed community and having at least one prior full-term pregnancy were associated with reduced engagement, with decreases of 7.9% (95% confidence interval [CI]: 1.2-14.6%) and 12.2% (95% CI: 5.2-19.1%), respectively. There was a nonsignificant trend toward increased detection of PEC with higher RPM engagement (odds ratio: 1.014, 95% CI: 0.999-1.846). Conclusion: Higher maternal age and first-time pregnancy were associated with increased RPM engagement, while living in a distressed community was linked to lower engagement. There was a nonsignificant positive association between RPM engagement and detection of PEC. Future studies should explore whether engagement with digital health platforms in prenatal care can modify risk factors for pregnancy complications.