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Oxford researchers awarded £2.5m funding for study involving 2,000 pregnant women.

Hypertension in pregnancy Shutterstock
We want to see if we can develop a simple and accurate way for pregnant women to measure their own blood pressure and urine from home.
- Dr Kath Tucker, University of Oxford

A new programme of research, led by the University of Oxford, will explore whether giving pregnant women the means to monitor their own blood pressure and urine safely from home can result in an earlier diagnosis of raised blood pressure (hypertension) and pre-eclampsia, for faster access to treatment.

Raised blood pressure during pregnancy affects around 1 in ten women worldwide, with around half developing pre-eclampisa. Pre-eclampsia, which can lead to seizures, is a major cause of death and premature birth in the UK and worldwide if not diagnosed early and accurately monitored.

The research has been funded by the National Institute for Health Research (NIHR) with a £2.5 million Programme Grant for Applied Research (PGfAR) award.

The largest of three separate studies will involve 2,000 pregnant women across London, Thames Valley and the West Midlands to determine whether self-monitoring of blood pressure between antenatal visits can be effective, acceptable, and cost effective compared to the usual care they would receive.

In addition, the researchers will recruit 300 pregnant women with raised blood pressure to explore whether self-testing for protein in urine – a marker of pre-eclampsia – is as good as testing by a midwife or health professional and if this could improve the diagnosis of pre-eclampsia. A further 160 women will be recruited into a study to investigate whether self-monitoring of blood pressure can help pregnant women with raised blood pressure to successfully adjust their medication.

Currently women who are at higher risk for developing blood pressure problems during pregnancy are monitored with more frequent antenatal clinic visits. But women can rapidly develop severe disease between these visits, and clinical teams only have the few intermittent clinic readings to make decisions about how best to treat any raised blood pressure.

Dr Kath Tucker, Research Fellow in Oxford University’s Nuffield Department of Primary Care Health Sciences, who is co-ordinating the programme of work, said:

“It is important for women with raised blood pressure, and in particular for those with pre-eclampsia, to receive their diagnosis as early as possible, so they can access treatment and reduce their risk of developing further complications for them and their baby. Typically women have their blood pressure and urine monitored every four weeks by a health professional during antenatal visits, but our previous research has shown women are both willing and able to monitor their own blood pressure and urine from home, which has the potential to identify problems much earlier.

“We want to see if we can develop a simple and accurate way for pregnant women to measure their own blood pressure and urine from home, and to determine whether this approach can improve the detection of raised blood pressure and pre-eclampsia diagnosis compared with usual antenatal care.”

The researchers will start by working with midwives, doctors and patients to develop a method of self-monitoring blood pressure and urine that is acceptable to women and can fit into usual clinical practice.

The work is a collaboration between the Universities of Oxford and Birmingham, City University of London, Queen Mary University of London and King’s College London, along with NHS Trusts in Oxford, Birmingham and London.

Read a lay summary about this project

Notes for editors:

For media enquiries contact Dan Richards-Doran.

About the National Institute for Health Research:

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed researchin the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

About the Univeristy of Oxford Medical Sciences Division:

Oxford University’s Medical Sciences Division is one of the largest biomedical research centres in Europe, with over 2,500 people involved in research and more than 2,800 students. The University is rated the best in the world for medicine and life sciences, and it is home to the UK’s top-ranked medical school. It has one of the largest clinical trial portfolios in the UK and great expertise in taking discoveries from the lab into the clinic. Partnerships with the local NHS Trusts enable patients to benefit from close links between medical research and healthcare delivery.

Within the division, the Nuffield Department of Primary Care Health Sciences undertakes internationally acclaimed teaching and research that improves the primary care that GP practices deliver, and is ranked top in the UK. The department’s research covers a broad range of primary care issues including cardiovascular and metabolic disease, health behaviours, infectious disease and child health, patient experience, research methods and evidence-based medicine. www.phc.ox.ac.uk