Category: Hypertension
Poster Session I
In nonpregnant adults, poor sleep is associated with higher blood pressure. We aimed to determine the impact of a novel neonatal sleep intervention on postpartum blood pressure in individuals with a hypertensive disorder of pregnancy (HDP).
Study Design:
In this single institution pilot randomized controlled trial, 110 individuals with a HDP were randomized to receive a neonatal sleep intervention, a SNOO smart bassinet, plus usual care of safe sleep education (n=54) or usual care alone (n=56). Individuals were included if they were 18+ years old, had a singleton term live birth of a non-anomalous infant without a prolonged neonatal intensive care unit stay, and had a new HDP without prior chronic hypertension. Remote follow-up visits were conducted at 1 and 6 weeks postpartum and involved obtaining blood pressure and weight. Routine postpartum care included participation in an institutionally-standard remote blood pressure monitoring program and a 6-week outpatient postpartum visit. Based on institutional data, our sample size had 80% power to detect a 4.5 mm Hg decrease in the primary outcome of mean arterial pressure (MAP) at 6 weeks postpartum.
Results:
Baseline characteristics were similar between arms (Table 1 and 2). Follow-up data were available for 102 (93%) participants at 1 week (mean 7.8±2.7 days) postpartum and for 104 (95%) participants at 6 weeks (mean 41.6±4.8 days) postpartum (Table 2). At 1 week postpartum, those in the intervention arm had lower MAP compared to those in the control arm (99±10 vs 103±7 mm Hg, p=0.04), and a lower rate of antihypertensive medication use (23% vs 35%, p=0.15). At 6 weeks postpartum, MAP was similar between arms (93±8 vs 94±8 mm Hg, p=0.54) but there was a non-statistically significant lower rate of antihypertensive use in the intervention arm (15% vs 26%, p=0.19).
Conclusion:
The SNOO bassinet as a neonatal sleep intervention did not result in improved MAP at 6 weeks postpartum in our cohort of individuals with HDP. There may be a lower rate of antihypertensive use through 6 weeks postpartum but this study was underpowered to detect this difference.
Tiffany Wang, MD
Magee-Womens Hospital, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Beth Quinn, MSN
Magee-Womens Hospital, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Renee Hart, BS
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania, United States
Alysia Wiener, MD
Magee-Womens Hospital, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Francesca Facco, MD
Associate Professor
Magee-Womens Hospital, University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Alisse Hauspurg, MD
Assistant Professor
University of Pittsburgh
Pittsburgh, Pennsylvania, United States
Hyagriv Simhan, MD,MSCR
Magee-Womens Hospital, University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States