Agreement between blood pressure from research study visits versus electronic medical records and associations with hypertensive disorder diagnoses in pregnant women with overweight/obesity.
Agreement between blood pressure from research study visits versus electronic medical records and associations with hypertensive disorder diagnoses in pregnant women with overweight/obesity.
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DOI：
10.1097/mbp.0000000000000542
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发表时间：
2021-10-01
影响因子：
1.3
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Lane-Cordova AD;Wilcox S;Fernhall B;Liu J
从电子病历(EMR)中提取的血压(BP)与非怀孕成年人的血压之间存在中等程度的相关性，但一致性有限。关于研究与怀孕期间测量的EMR BP的一致性或EMR BP与妊娠期高血压疾病(HDP)诊断的相关性，我们知之甚少。对214名孕前超重或肥胖的妇女(44.4%是非裔美国人，平均年龄为29.8±4.8岁)在怀孕16周和32周时，根据面对面研究访问的指导方针测量了血压。研究访问后1周内出现的临床血压读数从EMR中提取。我们使用皮尔逊系数评估来源之间的相关性；使用Bland-Altman曲线图评估一致性。我们比较了有高血压EMR血压测量和没有测量EMR BP的妇女在EMR中被诊断为HDP的比例的差异。来自研究访问的收缩压和舒张压与EMR在两个时间点都有中等到中度的相关性；0.20；r<；0.44，p<；0.05。妊娠早期平均收缩压差为10.5 mm Hg，平均舒张压差为1 mm Hg；妊娠晚期平均收缩压差为7.3 mm Hg，平均−差为1.7 mm Hg。EMR中至少有一个高血压血压读数的女性更有可能在EMR中记录有HDP诊断；43.5%对3.3%，p<；0.01。早孕期和晚孕期EMR收缩压较高，但与研究质量血压呈中等相关。有高血压EMR BP测量的女性在EMR中更有可能被诊断为HDP。
Blood pressure (BP) abstracted from electronic medical records (EMR) is moderately correlated to BP in non-pregnant adults with limited agreement. Little is known about the agreement of research versus EMR BP measured during pregnancy or associations of EMR BP with hypertensive disorder of pregnancy (HDP) diagnoses. BP was measured according to guidelines at in-person research study visits in 214 women with pre-pregnancy overweight or obesity (44.4% African American, mean age=29.8±4.8 yrs) at week 16 and 32 of pregnancy. Clinic BP readings that occurred within 1 week of the study visit were abstracted from the EMR. We assessed correlations between sources using Pearson’s coefficients; agreement was evaluated with Bland-Altman plots. We compared differences in the proportion of women with an HDP diagnosis in the EMR between women with versus without a hypertensive EMR BP measurement. Systolic and diastolic BP from study visits and the EMR were modestly-moderately correlated at both time points; 0.20<r<0.44, p<0.05 for all. The average mean difference was 10.5 mmHg for systolic and <1 mmHg for diastolic BP in early and 7.3 mmHg for systolic and −1.7 mmHg for diastolic BP in late pregnancy. Women with at least one hypertensive BP reading in the EMR were more likely to have an HDP diagnosis recorded in the EMR; 43.5% versus 3.3%, p<0.01. EMR systolic BP was higher but moderately correlated with research quality BP in early and late pregnancy. Women with a hypertensive EMR BP measurement were more likely to have an HDP diagnosis in the EMR.