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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

Open Access 01-12-2020 | Pre-Eclampsia | Research article

Investigating the current knowledge and needs concerning a follow-up for long-term cardiovascular risks in Dutch women with a preeclampsia history: a qualitative study

Authors: Tessa E. Dijkhuis, Femke Bloem, Lise A.J. Kusters, Sofie M. Roos, Sanne J. Gordijn, Floor Holvast, Jelmer R. Prins

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

There is increasing evidence that a history of preeclampsia is an important risk factor for future cardiovascular events. Awareness of this risk could provide opportunities for identification of women at risk, with opportunities for prevention and / or early intervention. A standardized follow-up has not yet been implemented in the north of the Netherlands. The objective of this qualitative study was to explore the opinions and wishes among women and physicians about the follow-up for women with a history of preeclampsia.

Methods

Semi-structured interviews with 15 women and 14 physicians (5 obstetricians, 4 general practitioners, 3 vascular medicine specialists and 2 cardiologists) were performed and addressed topics about knowledge on CVR, current - and future follow-up. Women were approached through the HELLP foundation and their physicians. Physicians were approached by email. The interviews were recorded, typed and coded using ATLAS.ti software. A theoretical-driven thematic analysis was performed.

Results

Women had some knowledge about the association between preeclampsia and the increased CVR, but missed information from their health care providers. Specialists were aware of the association, but the information and advice they provided to their patients was minimal and inconsistent according to themselves. Whereas some general practitioners regarded their own knowledge as limited. There was a clear desire among women for a more extensive follow-up with specific attention to both emotional and physical consequences of preeclampsia. Physicians indicated that they preferred to see a follow up program concerning the CVR at the general practitioner as part of the already existent cardiovascular risk management (CVRM) program.

Conclusion

Women and medical specialists consider it important to improve aftercare for women after a pregnancy complicated by preeclampsia. Introducing these women into the CVRM program at the general practitioner is regarded as a preferred first step. Further research is warranted to establish an evidence-based guideline for the follow-up of these women.
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Literature
1.
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, Hall DR, Warren CE, Adoyi G, Ishaku S, on behalf of the International Society for the Study of hypertension in pregnancy (ISSHP). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertension. 2018;13:291–310.PubMedCrossRef
2.
3.
4.
Kessous R, Shoham-Vardi I, Pariente G, Sergienko R, Sheiner E. Long-term maternal atherosclerotic morbidity in women with pre-eclampsia. Heart. 2015;101(6):442–6.PubMedCrossRef
5.
Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;28(1):1–19.PubMedCrossRef
6.
7.
Brouwers L, Meiden-van Roest A, Savelkoul C, Vogelvang T, Lely A, Franx A, et al. Recurrence of pre-eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta-analysis. BJOG Int J Obstet Gynaecol. 2018;125(13):1642–54.CrossRef
8.
Heida KY, Bots ML, Groot CJ, Dunne FM, Hammoud NM, Hoek A, et al. Cardiovascular risk management after reproductive and pregnancy-related disorders: a Dutch multidisciplinary evidence-based guideline. Eur J Prev Cardiol. 2016;23(17):1863–79.PubMedCrossRef
9.
Berks D, Hoedjes M, Raat H, Duvekot JJ, Steegers EA, Habbema JD. Risk of cardiovascular disease after preeclampsia and the effect of lifestyle interventions: a literature-based study. Obstet Anesth Dig. 2014;34(3):151.CrossRef
10.
Smith GN, Louis JM, Saade GR. Pregnancy and the postpartum period as an opportunity for cardiovascular risk identification and management. Obstet Gynecol. 2019;134(4):851–62.PubMedCrossRef
11.
Dong C, Rundek T, Wright CB, Anwar Z, Elkind MSV, Sacco RL. Ideal cardiovascular health predicts lower risks of myocardial infarction, stroke, and vascular death across whites, blacks, and Hispanics: the northern Manhattan study. Circulation. 2012;125(24):2975–84.PubMedPubMedCentralCrossRef
12.
Yang Q, Cogswell ME, Flanders WD, Hong Y, Zhang Z, Loustalot F, et al. Trends in Cardiovascular Health Metrics and Associations With All-Cause and CVD Mortality Among US Adults. JAMA. 2012;307(12):1273–83.PubMedCrossRef
13.
Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women - 2011 update a guideline from the American Heart Association. Circulation. 2011;123(11):1243–62.PubMedPubMedCentralCrossRef
14.
Cusimano MC, Pudwell J, Roddy M, Cho C-KJ, Smith GN. The maternal health clinic: an initiative for cardiovascular risk identification in women with pregnancy-related complications. Am J Obstetrics Gynecol. 2014;210(5):438 e9.CrossRef
15.
Spaan J, Peeters L, Spaanderman M, Brown M. Cardiovascular risk management after a hypertensive disorder of pregnancy. Hypertension. 2012;60(6):1368–73.PubMedCrossRef
16.
Groenhof TKJ, Rijn B, Franx A, Roeters van Lennep J, Bots M, Lely T. Preventing cardiovascular disease after hypertensive disorders of pregnancy: Searching for the how and when. Eur J Prev Cardiol. 2017;24(16):1735–45.PubMedPubMedCentralCrossRef
17.
Heidrich M, Wenzel D, von Kaisenberg CS, Schippert C, von Versen-Höynck FM. Preeclampsia and long-term risk of cardiovascular disease: what do obstetrician-gynecologists know? BMC Pregnancy Childbirth. 2013;13(1):61.PubMedPubMedCentralCrossRef
18.
Skurnik G, Roche AT, Stuart JJ, Rich-Edwards J, Tsigas E, Levkoff SE, et al. Improving the postpartum care of women with a recent history of preeclampsia: a focus group study. Hypertension Pregnancy. 2016;35(3):371–81.CrossRef
19.
O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51.PubMedCrossRef
20.
21.
22.
23.
24.
Seely EW, Rich-Edwards J, Lui J, Nicklas JM, Saxena A, Tsigas E, et al. Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study. BMC Pregnancy Childbirth. 2013;13(1):240.PubMedPubMedCentralCrossRef
25.
Young B, Hacker MR, Rana S. Physicians' knowledge of future vascular disease in women with preeclampsia. Hypertension Pregnancy. 2012;31(1):50–8.CrossRef
26.
van Kesteren F, Visser S, Hermes W, Teunissen PW, Franx A, van Pampus MG, et al. Counselling and management of cardiovascular risk factors after preeclampsia. Hypertension Pregnancy. 2016;35(1):55–61.CrossRef
27.
Nijdam M, Timmerman MR, Franx A, Bruinse HW, Numans ME, Grobbee DE, et al. Cardiovascular risk factor assessment after pre-eclampsia in primary care. BMC Fam Pract. 2009;10(1):77.PubMedPubMedCentralCrossRef
28.
Berks D, Hoedjes M, Raat H, Franx A, Looman CWN, Van Oostwaard MF, et al. Feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve risk factors for future cardiometabolic disease. Pregnancy Hypertens. 2019;15(98):107.
29.
Hoedjes M, Berks D, Vogel I, Duvekot JJ, Oenema A, Franx A, et al. Preferences for postpartum lifestyle counseling among women sharing an increased cardiovascular and metabolic risk: a focus group study. Hypertension Pregnancy. 2011;30(1):83–92.CrossRef
30.
Bokslag A, Kroeze W, de Groot CJM, Teunissen PW. Cardiovascular risk after preeclampsia: the effect of communicating risk factors on intended healthy behavior. Hypertension Pregnancy. 2018;37(2):98–103.CrossRef
31.
Brown MC, Bell R, Collins C, Waring G, Robson SC, Waugh J, et al. Women's perception of future risk following pregnancies complicated by preeclampsia. Hypertension Pregnancy. 2013;32(1):60–73.CrossRef
32.
Kaaya SF, Blander J, Antelman G, Cyprian F, Emmons KM, Matsumoto K, et al. Randomized controlled trial evaluating the effect of an interactive group counseling intervention for HIV positive women on prenatal depression and disclosure of HIV status. AIDS Care. 2013;25(7):854–62.PubMedCrossRef
Metadata
Title
Investigating the current knowledge and needs concerning a follow-up for long-term cardiovascular risks in Dutch women with a preeclampsia history: a qualitative study
Authors
Tessa E. Dijkhuis
Femke Bloem
Lise A.J. Kusters
Sofie M. Roos
Sanne J. Gordijn
Floor Holvast
Jelmer R. Prins
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Pre-Eclampsia
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03179-1

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