Screening for Chronic Medical Conditions

Hypertension

Providers should screen for hypertension with office blood pressure measurement in accordance with USPSTF recommendations.156 Ambulatory blood pressure monitoring and home blood pressure monitoring with validated and accurate devices can be used outside of a clinical setting to confirm a diagnosis of hypertension before starting treatment. Annual screening for hypertension in adults at increased risk for hypertension is recommended. Less frequent screening, every three to five years, is appropriate for adults ages 18 to 39 who are not at increased risk for hypertension and with a prior normal blood pressure reading. Providers should inform patients that hypertension in pregnancy can impact pregnancy outcomes, and close monitoring is critical.

Diabetes

Providers should screen adults ages 35 years and older with BMI ≥25 kg/m2 for prediabetes and Type 2 diabetes in accordance with USPSTF recommendations.157 Providers should offer or refer individuals with prediabetes and diabetes to effective prevention and treatment interventions. People with Type 1 or Type 2 diabetes should be encouraged to see a provider before trying to get pregnant, because diabetes increases risk of cesarean birth, large-for-gestational age babies, and children developing obesity or Type 2 diabetes in the future. Importantly, blood sugar goals are lower in pregnancy, so education and adjustments to medical management may be required. People with a history of gestational diabetes should be screened for Type 2 diabetes ideally within the first year postpartum, and every three years afterwards, for a minimum of 10 years after pregnancy.158