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.

查看原文本刊更多论文

妊娠期间高血压疾病和糖尿病后的心血管风险管理，在多种族人群中：一项妇女和医疗保健提供者的定性研究

妊娠并发症如妊娠糖尿病和高血压疾病会增加产妇心血管风险。然而，关于如何在多民族背景下最好地实施心血管风险管理（CVRM）的证据仍然有限。尽管不同种族的心血管疾病风险和妊娠并发症风险存在差异，但现有的研究主要集中在白人人群上。目的从妇女和医疗保健提供者的角度探讨产后心血管疾病的经验、障碍和改进措施，旨在加强多民族背景下心血管疾病的预防。研究设计：我们对25名患有妊娠期高血压疾病或妊娠期糖尿病的产后妇女进行了半结构化访谈，这些妇女被招募来反映不同的种族和社会经济背景。使用叙述的方法，采访涵盖了crvrm的经验和偏好。主题与16个医疗保健提供者（包括全科医生、助产士和专家）的调查结果进行了三角分析，讨论了护理交付、最佳实践和多民族考虑。结果被整合到患者旅程图中。结果在从产科转到初级保健和长期监测期间，特别是少数民族和社会经济地位较低和疾病严重程度较低的妇女中，出现了显著的辍学率。妇女往往缺乏风险意识，并错过了随访时，需要自行安排。大多数人支持量身定制的心血管风险教育、生活方式干预和积极主动的外展。医疗保健提供者强调需要跨学科交流、区域协议和更明确的指导方针，并指出全科医生对常规监测的支持存在差异。结论通过积极的外展、更好的随访利用、有文化针对性的干预措施和区域性多学科协议来简化护理和解决指南不一致的问题，可以改善多民族背景下的产后CVRM。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.