Cardiovascular risk management after hypertensive disorders and diabetes during pregnancy, in a multi-ethnic population: A qualitative study among women and healthcare providers

IF 2.5 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-02-21 DOI:10.1016/j.preghy.2025.101203

Annemarie Y.A.M. Reilingh , Renée J. Burger , Souraya el Bachiri , Stephen McCarthy , Sanne J. Gordijn , Wessel Ganzevoort , Irene G.M. Valkengoed van , on behalf of the project group: ’Obstetric history and cardiovascular health across ethnicity, in The Netherlands’

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引用次数: 0

Abstract

Background

Pregnancy complications like gestational diabetes and hypertensive disorders increase maternal cardiovascular risk. However, evidence on how to best implement cardiovascular risk management (CVRM) in multi-ethnic contexts remains limited. Existing studies primarily focus on white populations, despite disparities in CVD risk and the risk of pregnancy complications across ethnic groups.

Objective

This study explores experiences, barriers, and improvements in postpartum CVRM from women’s and healthcare providers’ perspectives, aiming to enhance cardiovascular disease prevention in multi-ethnic contexts.

Study Design

We conducted semi-structured interviews with 25 postpartum women who experienced hypertensive disorders of pregnancy or gestational diabetes, recruited to reflect diverse ethnic and socioeconomic backgrounds. Using a narrative approach, interviews covered CVRM experiences and preferences. Themes were triangulated with findings from 16 healthcare providers, including general practitioners, midwives, and specialists, discussing care delivery, optimal practices, and multi-ethnic considerations. Results were integrated in a patient journey map.

Results

Significant dropout occurred at the transition from obstetric to primary care and during long-term monitoring, especially among ethnic minorities and women with lower socioeconomic status and disease severity. Women often lacked risk awareness and missed follow-ups when self-scheduling was required. Most supported tailored cardiovascular risk education, lifestyle interventions, and proactive outreach. Healthcare providers emphasized the need for interdisciplinary communication, regional protocols, and clearer guidelines, noting variability in general practitioners’ support for routine monitoring.

Conclusion

Postpartum CVRM in multi-ethnic contexts could be improved with active outreach, better follow-up utilization, culturally tailored interventions, and regional multidisciplinary protocols to streamline care and address guideline inconsistencies.

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来源期刊

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health OBSTETRICS & GYNECOLOGYPERIPHERAL VASCULAR-PERIPHERAL VASCULAR DISEASE

CiteScore

4.90

自引率

0.00%

发文量

127

期刊介绍： Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field. We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.