This summer, the news hit hard. Finding out that track star Tori Bowie died from complications of childbirth left us all stunned and puzzled. An autopsy report shared with The New York Times listed respiratory distress and eclampsia (an acute advancement of preeclampsia) as possible complications. She won three Olympic medals and two world championships. How could a healthy, elite athlete die as a possible result of untreated preeclampsia?
In my years as an RN in a maternity unit, I've come to know preeclampsia as a silent killer. Most pregnant patients can't feel their blood pressure going up. Other symptoms mimic the most basic everyday aches and growing pains of pregnancy (headache, nausea/vomiting, swelling of the face and hands, and unexplained anxiety). It makes it easy for women to miss early warning signs if they aren't aware of what to look out for or shake concerning symptoms off as normal aspects of their care journeys.
With maternal health in the U.S. facing urgent crises like it rarely has before, understanding and addressing the causes of tragic pregnancy outcomes is paramount. Let’s explore what leads to preeclampsia, the implications of ongoing gaps in care, and how digital health can help bridge them.
Fast facts about preeclampsia in U.S. maternity patients
Preeclampsia is a serious medical condition affecting some perinatal patients, characterized by the sudden onset of high blood pressure and possible organ damage. It can cause significant harm to individuals during maternal care journeys — and, in the worst cases, deadly outcomes. Though treatments for this complication have improved over the years, a lot of ambiguity still surrounds how to identify it early. Here are some important facts you should know:
1. Preeclampsia is on the rise
Preeclampsia has been on the rise for a couple of decades. However, among other concerning trends in healthcare, medical professionals saw a particularly dramatic uptick in this condition during the pandemic. Currently, preeclampsia affects one out of every 25 pregnancies, with patients particularly susceptible if they face preexisting conditions (such as diabetes, obesity, chronic high blood pressure, Lupus, kidney disease and preeclampsia during a previous maternal care journey), who underwent in-vitro fertilization, or with a family history of preeclampsia.
2. Preeclampsia is tied to health disparities
Several factors contribute to higher rates among maternity patients in the U.S. — namely barriers to accessing high-quality care. Specifically, SDOH are increasingly tied to differing preeclampsia rates. For instance, Black American mothers are 60% more likely to develop preeclampsia than their white counterparts. Comorbidities such as hypertension and obesity are largely tied to limited access to care in this population. And with new studies finding Black immigrant maternity patient populations less likely to experience this complication than those in Black American communities, the evidence points to societal disparities as likely contributors.
Find out how one health system leveraged Memora Health’s platform to support at-risk maternity patients.
3. Resulting mortality can be prevented
Preeclampsia often occurs on or close to delivery dates, making it more likely to be identified and treated in a clinical setting. However, others develop this condition before their due dates or even after giving birth. Regardless of where patients encounter preeclampsia throughout the perinatal journey, it’s generally determined that six out of 10 mortalities due to preeclampsia are preventable — and advancements in monitoring and patient education are at the crux of helping improve prevention.
4. Tests to predict preeclampsia are just emerging
Despite preeclampsia posing a significant threat to maternity patients, effective testing to truly predict the development of this dangerous condition has only recently shown progress. For instance, researchers at Emory University just developed an exam that considers a variety of risk factors — including high blood pressure, in-vitro fertilization, and other preexisting contributors — for successfully predicting preeclampsia in patients. However, it still doesn’t account for the emergence of this condition in scenarios where these predetermining variables are absent, possibly leaving out a sizable number of cases. More research needs to be done about genetic predispositions for developing preeclampsia to push testing efforts further.
How intelligent care enablement can empower providers and patients to address preeclampsia
There isn’t one clear medical solution for preventing preeclampsia. And with examinations to determine the probability of this condition still in development, maternity patients and their providers need augmented modes for monitoring risk factors, understanding patient behavior away from the hospital, and providing assistance throughout care journeys.
That’s where technology can play its part. Intelligent care enablement — scalable technology that supports patients and providers through complex clinical episodes — consistently monitors maternity patients’ statuses, and proactively collects care-related information for their clinicians. Some particular advantages for supporting patients at-risk for developing preeclampsia include:
1. Reinforcing consistent remote patient monitoring (RPM)
RPM is an essential aspect of care delivery for chronic conditions, including in cases of cardiovascular disease and diabetes. It’s also used to support maternity patients in monitoring blood pressure or help providers keep a pulse on at-risk patients. However, RPM data can be overwhelming for care teams to collect, organize, and analyze.
Consistently monitoring blood pressure and checking in with patients about the signs and symptoms of preeclampsia, Memora Health’s intelligent care enablement platform streamlines RPM during perinatal care journeys. It automatically collects RPM information, organizes it, and presents it to care teams in a highly accessible, visualized patient view.
Importantly, our conversational AI also knows when to flag concerning messages to care teams, simplifying the triage process and allowing for more rapid, real-time, thorough course-corrections early on. Not only could this expanded ability to track treatment plans help save lives by identifying risks before they contribute to acute care episodes, but it can help break down barriers to care by giving all patients support throughout their perinatal care journeys.
2. Encouraging lifestyle modification for maternity patients
In addition to preexisting conditions that can contribute to preeclampsia, certain lifestyle choices and behavioral patterns can affect outcomes. For instance, research has tied physical activity before and during pregnancy to reduced instances of preeclampsia.
However, most routines happen outside of the clinical setting during maternity care journeys. And supporting patients to embrace positive habits in their daily lives can be challenging without the right tools for supporting them before, after, and between appointments.
That’s why Memora’s high-risk maternity Care Programs are built with lifestyle modification in mind. They consistently educate patients on ideal care guidelines, nutrition, lifestyle routines, and more to ensure they have all of the information they need to take the right steps to help prevent adverse pregnancy outcomes.
3. Supporting better medication adherence
There’s resounding evidence that regularly taking certain medications — such as aspirin — could help reduce the chances of developing preterm preeclampsia.
But following treatment plans is easier said than done. In fact, one study found that around a third of pregnant patients facing chronic conditions didn’t take their prescriptions as directed.
Memora Health uses SMS text messaging to proactively support medication adherence. Our conversational AI engages patients — asking them if they’ve missed doses — then catalogs that data and flags concerning compliance trends for providers. By giving clinicians robust insights into their maternity patients’ lives away from the hospital, more effective prescription-related interventions can be made to keep individuals on the right path and help prevent preeclampsia scenarios before they happen.
4. Fostering equitable care by streamlining SDOH assessments
As outlined before, SDOH are increasingly associated with higher instances of preeclampsia. These factors can include racial or ethnic inequities, proximity to a care provider, lack of transportation, food insecurity, and more.
But there’s no one-size-fits-all approach to delivering equitable care. Every community has its own unique challenges, and patients need more personalized interventions to truly make a difference.
The way our platform helps with this is two-fold. First, it proactively collects SDOH data to help providers glean crucial insights about their patient populations and understand how to intervene to provide effective support. Secondly, Memora Health’s Care Programs are built with conversational AI that can independently determine when patients encounter barriers — such as lacking transportation options for attending appointments — then surface actionable resources they can use to help them overcome challenges. Notably, it does all of this through texting so that even patients without access to the internet can receive engaging and effective support.
Advancements in preventing preeclampsia still have a long way to go. But technology can play a critical role in healing gaps in care to promote better outcomes and empower providers and patients to monitor potential red flags. And intelligent care enablement innovations that support better RPM, encourage positive lifestyle changes, reinforce medication adherence, and give providers in-depth SDOH data do just that.
Ready to see how our evidence-based Care Programs adapt to your workflows? Speak with one of our experts today!