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Ghisi GLDM, Banks L, Cotie LM, Pakosh M, Pollock C, Nerenberg K, Gagliardi A, Smith G, Colella TJ. Women's Knowledge of Future Cardiovascular Risk Associated With Complications of Pregnancy: A Systematic Review. CJC Open 2024; 6:182-194. [PMID: 38487070 PMCID: PMC10935684 DOI: 10.1016/j.cjco.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/05/2023] [Indexed: 03/17/2024] Open
Abstract
Background Several common pregnancy conditions significantly increase a woman's risk of future cardiovascular diseases (CVD). Patient education and interventions aimed at awareness and self-management of cardiovascular risk factors may help modify future cardiovascular risk. The aim of this systematic review was to examine education interventions for cardiovascular risk after pregnancy, clinical measures/scales, and knowledge outcomes in published qualitative and quantitative studies. Methods Five databases were searched (from inception to June 2023). Studies including interventions and validated and nonvalidated measures of awareness/knowledge of future cardiovascular risk among women after complications of pregnancy were considered. Quality was rated using the Mixed Methods Appraisal Tool. Results were analyzed using the Synthesis Without Meta-analysis reporting guideline. Characteristics of interventions were reported using the Template for Intervention Description and Replication. Fifteen studies were included; 3 were randomized controlled trials. Results In total, 1623 women had a recent or past diagnosis of hypertensive disorders of pregnancy, gestational diabetes mellitus, and/or premature birth. Of the 7 studies that used online surveys or questionnaires, 2 reported assessing psychometric properties of tools. Four studies used diverse educational interventions (pamphlets, information sheets, in-person group sessions, and an online platform with health coaching). Overall, women had a low level of knowledge about their future CVD risk. Interventions were effective in increasing this knowledge. Conclusions In conclusion, women have a low level of knowledge of risk of CVD after pregnancy complications. To increase this level of knowledge and self-management, this population has a strong need for psychometrically validated tailored education interventions.
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Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, KITE, University Health Network, Toronto, Ontario, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Laura Banks
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, KITE, University Health Network, Toronto, Ontario, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Lisa M. Cotie
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, KITE, University Health Network, Toronto, Ontario, Canada
| | - Maureen Pakosh
- Library & Information Services, KITE, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Courtney Pollock
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kara Nerenberg
- Departments of Medicine, Obstetrics & Gynecology, Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Anna Gagliardi
- Toronto General Hospital Research Institute and University of Toronto, Toronto, Ontario, Canada
| | - Graeme Smith
- Department of Obstetrics & Gynecology, Queen’s University, Kingston, Ontario, Canada
| | - Tracey J.F. Colella
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, KITE, University Health Network, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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Patil H, Kotireddy J, Shitole A, Patil S. Maternal and fetal outcomes among pregnant women with cardiac disease attending a tertiary care hospital: A prospective observational study. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_393_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Kasargod Prabhakar CR, Pamment D, Thompson PJ, Chong H, Thorne SA, Fox C, Morris K, Hudsmith LH. Pre-conceptual counselling in cardiology patients: still work to do and still missed opportunities. A comparison between 2015 and 2019 in women with cardiac disease attending combined obstetric cardiology clinics. Should the European Guidelines change anything? Cardiol Young 2022; 32:64-70. [PMID: 34030760 DOI: 10.1017/s1047951121001530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Women with underlying cardiac conditions have an increased risk of adverse pregnancy outcomes. Counselling reproductive age women with heart disease is important to assist them in deciding whether to pursue pregnancy, to ensure their best cardiovascular status prior to pregnancy, and that they understand the risks of pregnancy for them and baby. This also provides an opportunity to explore management strategies to reduce risks. For this growing cohort of women, there is a great need for pre-conceptual counselling.This retrospective comparative audit assessed new referrals and pre-conceptual counselling of women attending a joint obstetric-cardiology clinic at a tertiary maternity centre in a 12-month period of 2015-2016 compared with 2018-2019. This reflected the timing of the introduction of a multidisciplinary meeting prior to clinics and assessed the impact on referrals with the introduction of the European Society of Cardiology guidelines.Data were reviewed from 56 and 67 patients in respective audit periods. Patient's risk was stratified using modified World Health Organization classification.Less than 50% of women with pre-existing cardiac conditions had received pre-conceptual counselling, although half of them had risks clearly documented. The majority of patients had a recent electrocardiograph and echocardiogram performed prior to counselling, and there was a modest improvement in the number of appropriate functional tests performed between time points. One-third of patients in both cohorts were taking cardiac medications during pregnancy.There was a significant increase in the number of pregnant women with cardiac disease and in complexity according to modified World Health Organization risk classification. While there have been improvements, it is clear that further work to improve availability and documentation of pre-pregnancy counselling is needed.
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Affiliation(s)
| | - Daisy Pamment
- University of Birmingham Medical School, Birmingham, UK
| | | | - Hsu Chong
- The Rosie Maternity Hospital, Cambridge, UK
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Affiliation(s)
- Cornelia R Graves
- Tennesee Maternal Fetal Medicine, Nashville (C.R.G.) .,Department of Obstetrics and Gynecology (C.R.G.).,Collaborative Perinatal Cardiac Center, Nashville, TN (C.R.G., S.F.D.).,University of Tennessee, Vanderbilt University, Nashville (C.R.G.).,Meharry Medical College, Nashville, TN (C.R.G.)
| | - Stacy F Davis
- Department of Cardiology (S.F.D.), St. Thomas Health Systems, Nashville, TN .,Collaborative Perinatal Cardiac Center, Nashville, TN (C.R.G., S.F.D.).,St Thomas Midtown Comprehensive Heart Failure Center, Nashville, TN (S.F.D.)
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