Objective: Clinical evaluation and user experience of the Cloud DX connected HealthKit Pulsewave wrist cuff blood pressure monitor (CDXP) for home blood pressure monitoring during pregnancy (HBPM). Methods: In the first phase, an adjusted version of the European Society of Hypertension International Protocol Revision 2010 (ESH-IP 2010) was used to compare the CDXP and Omron M6 Comfort to the aneroid manometer. In the second phase, blood pressure measurement at home was compared to standard office blood pressure measurement (OBPM). Patients filled out a questionnaire regarding user experience. Results: In 34 pregnant women the blood pressure measured by the aneroid manometer did not differ from the CDXP (systolic blood pressure (SBP) difference: -0.7±6.5 mmHg (p=0.38), diastolic blood pressure (DBP) difference: 0.4±5.7 mmHg (p=0.55)), while the aneroid manometer measured SBP slightly higher (1.5±5.8 mmHg (p=0.04)) and DBP slightly lower (-2.8±5.8 mmHg (p<0.01)) as compared to the Omron M6 Comfort. In 32 patients the SBP of the office hospital measurement was significantly higher, while DBP was comparable. The mean user experience score for the CDXP was 85%, corresponding with an ‘excellent’ evaluation. Of all patients, 97% reported they liked the idea of home monitoring and would like to use it in the future. Conclusion: The CDXP is as reliable as standard office blood pressure monitors during pregnancy and gives a better representation of the blood pressure than standard hospital measurement. Pregnant women are positive and confident about HBPM and find the CDXP easy to use.

Objective: To determine associations of calcium-based antacid and PPI use during pregnancy with late-onset preeclampsia (≥34 weeks of gestation), taking into account dosage and timing of use. Design: Prospective cohort study. Setting: This study used data from the PRIDE Study (2012-2019) and Dutch Pregnancy Drug Register (2014-2019). Sample: A total of 9,058 pregnant Dutch women aged ≥18 years. Methods: Data were collected through web-based questionnaires and obstetric records. We estimated risk ratios (RRs) for late-onset preeclampsia for any use and trajectories of calcium-based antacid and PPI use before gestational day 238, and hazard ratios for time-varying exposures after gestational day 237. Main outcome measure: Late-onset preeclampsia. Results: Late-onset preeclampsia was diagnosed in 2.6% of pregnancies. Any use of calcium-based antacids (RR 1.2 [95% CI 0.9-1.6]) or PPIs (RR 1.4 [95% CI 0.8-2.4]) before gestational day 238 was not associated with late-onset preeclampsia. Use of low-dose calcium-based antacids in gestational weeks 0-16 (<1g/day; RR 1.8 [95% CI 1.1-2.9]) and any use of PPIs in gestational weeks 17-33 (RR 1.6 [95% CI 1.0-2.8]) seemed to increase risks of late-onset preeclampsia. We did not observe associations between late-onset preeclampsia and use of calcium-based antacids and PPIs after gestational day 237. Conclusions: In this prospective cohort study, use of calcium-based antacids and PPIs during pregnancy was not found to reduce the risk of late-onset preeclampsia. Funding: Netherlands Organisation for Health Research and Development [ZonMw; grant number 848018010].