Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Preeclampsia and long-term risk of cardiovascular disease: what do obstetrician-gynecologists know?

Authors: May-Britt Heidrich, Daniela Wenzel, Constantin S von Kaisenberg, Cordula Schippert, Frauke M von Versen-Höynck

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

Login to get access

Abstract

Background

Preeclampsia (PE), a hypertensive disorder of pregnancy affects 2-8% of women and is associated with increased cardiovascular disease (CVD) risk later in life. There is little information about the knowledge of obstetrician-gynecologists in German outpatient care setting regarding the future health risk of PE and knowledge of the current guidelines on treatment and counseling patients post PE. This study aimed to assess whether obstetrician-gynecologists are aware of PE’s association with maternal long-term adverse outcomes and providing appropriate counseling.

Methods

A random sample of 500 obstetrician-gynecologists in the federal state of Lower Saxony was mailed a survey and a reminder with a second copy of the survey. The questionnaire elicited both personal information, and knowledge on future disease risks, e.g. cardiovascular disease (CVD) and current guidelines as well as on counseling practice. Descriptive analysis was used to analyze the responses.

Results

A total of 212 obstetrician-gynecologists (42.4%) responded to the questionnaire. A large proportion of physicians stated that PE was associated with a higher risk for the development for hypertension (86.6%), stroke (78.5%) and kidney disease (78.0%). Of the participants 75.8% reported that women after PE have a shorter life expectancy. Respondents with knowledge of the current guidelines of the German Association of Obstetrics and Gynecology concerning follow up and risk management of PE (45.2%) were more often aware of the development of CVD and stroke and counseled patients on self -blood-pressure measurement, meaning and long-term-risks of PE and attached importance to family history of PE compared to physicians with no knowledge of the guidelines.

Conclusion

Although the majority of obstetrician-gynecologists were aware of higher CVD risk after PE, weaknesses exist in the follow up care and counseling of these patients. These deficiencies would be amendable to directed educational activities to improve the implementation of current guidelines.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ghulmiyyah L, Sibai B: Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 36 (1): 56-59. Ghulmiyyah L, Sibai B: Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 36 (1): 56-59.
2.
go back to reference Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R: Pre-eclampsia. Lancet. 376 (9741): 631-644. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R: Pre-eclampsia. Lancet. 376 (9741): 631-644.
3.
go back to reference ACOG Committee on Practice Bulletins—Obstetrics: Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002, 99 (1): 159-167. 10.1016/S0029-7844(01)01747-1.CrossRef ACOG Committee on Practice Bulletins—Obstetrics: Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002, 99 (1): 159-167. 10.1016/S0029-7844(01)01747-1.CrossRef
4.
go back to reference Redman CW, Sargent IL: The pathogenesis of pre-eclampsia. Gynecol Obstet Fertil. 2001, 29 (7–8): 518-522.CrossRefPubMed Redman CW, Sargent IL: The pathogenesis of pre-eclampsia. Gynecol Obstet Fertil. 2001, 29 (7–8): 518-522.CrossRefPubMed
5.
go back to reference Sattar N, Ramsay J, Crawford L, Cheyne H, Greer IA: Classic and novel risk factor parameters in women with a history of preeclampsia. Hypertension. 2003, 42 (1): 39-42. 10.1161/01.HYP.0000074428.11168.EE.CrossRefPubMed Sattar N, Ramsay J, Crawford L, Cheyne H, Greer IA: Classic and novel risk factor parameters in women with a history of preeclampsia. Hypertension. 2003, 42 (1): 39-42. 10.1161/01.HYP.0000074428.11168.EE.CrossRefPubMed
6.
go back to reference Bellamy L, Casas JP, Hingorani AD, Williams DJ: Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007, 335 (7627): 974-10.1136/bmj.39335.385301.BE.CrossRefPubMedPubMedCentral Bellamy L, Casas JP, Hingorani AD, Williams DJ: Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007, 335 (7627): 974-10.1136/bmj.39335.385301.BE.CrossRefPubMedPubMedCentral
7.
go back to reference Jonsdottir LS, Arngrimsson R, Geirsson RT, Sigvaldason H, Sigfusson N: Death rates from ischemic heart disease in women with a history of hypertension in pregnancy. Acta Obstet Gynecol Scand. 1995, 74 (10): 772-776. 10.3109/00016349509021195.CrossRefPubMed Jonsdottir LS, Arngrimsson R, Geirsson RT, Sigvaldason H, Sigfusson N: Death rates from ischemic heart disease in women with a history of hypertension in pregnancy. Acta Obstet Gynecol Scand. 1995, 74 (10): 772-776. 10.3109/00016349509021195.CrossRefPubMed
8.
go back to reference MacDonald SE, Walker M, Ramshaw H, Godwin M, Chen XK, Smith G: Hypertensive disorders of pregnancy and long-term risk of hypertension: what do Ontario prenatal care providers know, and what do they communicate?. J Obstet Gynaecol Can. 2007, 29 (9): 705-710.CrossRefPubMed MacDonald SE, Walker M, Ramshaw H, Godwin M, Chen XK, Smith G: Hypertensive disorders of pregnancy and long-term risk of hypertension: what do Ontario prenatal care providers know, and what do they communicate?. J Obstet Gynaecol Can. 2007, 29 (9): 705-710.CrossRefPubMed
9.
go back to reference Wilson BJ, Watson MS, Prescott GJ, Sunderland S, Campbell DM, Hannaford P, Smith WC: Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ. 2003, 326 (7394): 845-10.1136/bmj.326.7394.845.CrossRefPubMedPubMedCentral Wilson BJ, Watson MS, Prescott GJ, Sunderland S, Campbell DM, Hannaford P, Smith WC: Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ. 2003, 326 (7394): 845-10.1136/bmj.326.7394.845.CrossRefPubMedPubMedCentral
10.
go back to reference Smith GC, Pell JP, Walsh D: Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births. Lancet. 2001, 357 (9273): 2002-2006. 10.1016/S0140-6736(00)05112-6.CrossRefPubMed Smith GC, Pell JP, Walsh D: Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129,290 births. Lancet. 2001, 357 (9273): 2002-2006. 10.1016/S0140-6736(00)05112-6.CrossRefPubMed
11.
go back to reference Libby G, Murphy DJ, McEwan NF, Greene SA, Forsyth JS, Chien PW, Morris AD: Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort. Diabetologia. 2007, 50 (3): 523-530. 10.1007/s00125-006-0558-z.CrossRefPubMed Libby G, Murphy DJ, McEwan NF, Greene SA, Forsyth JS, Chien PW, Morris AD: Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort. Diabetologia. 2007, 50 (3): 523-530. 10.1007/s00125-006-0558-z.CrossRefPubMed
12.
go back to reference Vikse BE, Irgens LM, Leivestad T, Skjaerven R, Iversen BM: Preeclampsia and the risk of end-stage renal disease. N Engl J Med. 2008, 359 (8): 800-809. 10.1056/NEJMoa0706790.CrossRefPubMed Vikse BE, Irgens LM, Leivestad T, Skjaerven R, Iversen BM: Preeclampsia and the risk of end-stage renal disease. N Engl J Med. 2008, 359 (8): 800-809. 10.1056/NEJMoa0706790.CrossRefPubMed
13.
go back to reference Berg CJ, Atrash HK, Koonin LM, Tucker M: Pregnancy-related mortality in the United States, 1987-1990. Obstet Gynecol. 1996, 88 (2): 161-167. 10.1016/0029-7844(96)00135-4.CrossRefPubMed Berg CJ, Atrash HK, Koonin LM, Tucker M: Pregnancy-related mortality in the United States, 1987-1990. Obstet Gynecol. 1996, 88 (2): 161-167. 10.1016/0029-7844(96)00135-4.CrossRefPubMed
14.
go back to reference Harskamp RE, Zeeman GG: Preeclampsia: at risk for remote cardiovascular disease. Am J Med Sci. 2007, 334 (4): 291-295. 10.1097/MAJ.0b013e3180a6f094.CrossRefPubMed Harskamp RE, Zeeman GG: Preeclampsia: at risk for remote cardiovascular disease. Am J Med Sci. 2007, 334 (4): 291-295. 10.1097/MAJ.0b013e3180a6f094.CrossRefPubMed
15.
go back to reference Mongraw-Chaffin ML, Cirillo PM, Cohn BA: Preeclampsia and cardiovascular disease death: prospective evidence from the child health and development studies cohort. Hypertension. 2010, 56 (1): 166-171. 10.1161/HYPERTENSIONAHA.110.150078.CrossRefPubMedPubMedCentral Mongraw-Chaffin ML, Cirillo PM, Cohn BA: Preeclampsia and cardiovascular disease death: prospective evidence from the child health and development studies cohort. Hypertension. 2010, 56 (1): 166-171. 10.1161/HYPERTENSIONAHA.110.150078.CrossRefPubMedPubMedCentral
17.
go back to reference Irgens HU, Reisaeter L, Irgens LM, Lie RT: Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ. 2001, 323 (7323): 1213-1217. 10.1136/bmj.323.7323.1213.CrossRefPubMedPubMedCentral Irgens HU, Reisaeter L, Irgens LM, Lie RT: Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ. 2001, 323 (7323): 1213-1217. 10.1136/bmj.323.7323.1213.CrossRefPubMedPubMedCentral
18.
go back to reference Magnussen EB, Vatten LJ, Smith GD, Romundstad PR: Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol. 2009, 114 (5): 961-970. 10.1097/AOG.0b013e3181bb0dfc.CrossRefPubMed Magnussen EB, Vatten LJ, Smith GD, Romundstad PR: Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol. 2009, 114 (5): 961-970. 10.1097/AOG.0b013e3181bb0dfc.CrossRefPubMed
19.
go back to reference Bundesärztekammer (BÄK) AdWMFA: Kassenärztliche Bundesvereinigung (KBV). 2005, Methoden-Report: Nationales Programm für Versorgungs-Leitlinien Bundesärztekammer (BÄK) AdWMFA: Kassenärztliche Bundesvereinigung (KBV). 2005, Methoden-Report: Nationales Programm für Versorgungs-Leitlinien
20.
go back to reference Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen: Arbeitsgemeinschaft Schwangerschaftshochdruck/Gestose AWMF. 2010, Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), 015/018 (S2) Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen: Arbeitsgemeinschaft Schwangerschaftshochdruck/Gestose AWMF. 2010, Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), 015/018 (S2)
21.
Metadata
Title
Preeclampsia and long-term risk of cardiovascular disease: what do obstetrician-gynecologists know?
Authors
May-Britt Heidrich
Daniela Wenzel
Constantin S von Kaisenberg
Cordula Schippert
Frauke M von Versen-Höynck
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-61

Other articles of this Issue 1/2013

BMC Pregnancy and Childbirth 1/2013 Go to the issue