The feasibility of multimodality remote monitoring of maternal physiology during pregnancy

Gestational hypertension affects 10% of pregnancies, may occur without warning, and has wide-ranging effects on maternal, fetal, and infant health. Antenatal care largely relies on in-person appointments; hence, only <4% of the pregnancy period is subject to routine clinical monitoring. Home monitoring offers a unique opportunity to collect granular data and identify trends in maternal physiology that could predict pregnancy compromise. Our objective was to investigate the feasibility of remote multidomain monitoring of maternal cardiovascular health both in and after pregnancy. This was a prospective feasibility study of continuous remote monitoring of multiple modalities indicative of cardiovascular health from the first trimester to 6 weeks postpartum. Twenty-four pregnant women were asked to monitor body weight, heart rate, blood pressure, activity levels, and sleep patterns daily. Study participants took on average 4.3 (standard deviation [SD] = 2.20) home recordings of each modality per week across the 3 trimesters and 2.0 postpartum (SD = 2.41), out of a recommended maximum of 7. Participant retention was 58.3%. Wearing a smartwatch daily was reported as feasible (8.6/10, SD = 2.3) and data could be entered digitally with ease (7.7/10, SD = 2.4). Remote digital monitoring of cardiovascular health is feasible for research purposes and hence potentially so for routine clinical care throughout and after pregnancy. Fifty-eight percent of women completed the study. Multiple modalities indicative of cardiovascular health can be measured in parallel, giving a global view that is representative of the whole pregnancy period in a way that current antenatal care is not. CONDENSED ABSTRACT: To ascertain whether remote multimodality cardiovascular monitoring of health in pregnancy is feasible, 24 participants were asked to daily monitor body weight, heart rate, blood pressure, activity levels, and sleep patterns. Study participants took on average 4.3 (standard deviation = 2.20) home recordings of each modality per week across the 3 trimesters and 2.0 postpartum (standard deviation = 2.41), out of a recommended maximum of 7. Thus, remote monitoring indicative of cardiovascular health throughout and after pregnancy might be feasible for routine clinical care or within the context of a research study.