Mind the evidence gap: lack of validated blood pressure devices for pregnant patients.

Abstract

Blood pressure measurement is essential for diagnosing hypertensive disorders in pregnancy, yet many automated monitors in Canada lack pregnancy-specific validation. Pregnancy causes cardiovascular changes that may affect the accuracy of oscillometric devices. Despite this limitation, it remains unclear which automated devices used in clinics and at home are validated for pregnancy, and many monitors, particularly in rural and Indigenous communities may be used without confirmed validation. Hypertension Canada guidelines acknowledge this gap in blood pressure assessments during pregnancy. Evidence shows automated devices can produce clinically meaningful inaccuracies, leading to under- or overdiagnosis of hypertensive disorders of pregnancy. Addressing this issue requires pregnancy-specific validation studies, regulatory attention, and increased clinical awareness to ensure accurate and equitable maternal care.