Abstract
IntroductionCertain complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, intrauterine growth restriction, spontaneous preterm birth, and placental abruption, are established independent risk factors for premature cardiovascular disease in women. Metabolic syndrome, which is associated with an increased risk of cardiovascular disease, may be a suitable alternative to traditional cardiovascular risk calculators that underestimate risk in young women. This study aimed to investigate the prevalence of metabolic syndrome in women who experienced a complicated pregnancy 6 months earlier.MethodsThis observational study investigated the prevalence of metabolic syndrome as defined by the International Diabetes Federation in all eligible participants (n = 247) attending a postpartum lifestyle intervention clinic from August 2018 to June 2021 at the Lyell McEwin Hospital in Adelaide, South Australia.ResultsA total of 89 (36%) participants met the criteria for metabolic syndrome at a mean follow up time of 7 months postpartum. Almost 90% of the cohort were abdominally obese, and over two thirds of the total cohort met at least two of the criteria for metabolic syndrome.ConclusionsWomen with a prior history of one of the common major pregnancy complications are at high risk of future cardiovascular and metabolic disease, with many showing either metabolic syndrome or multiple risk factors at only 7 months postpartum. The results indicate that follow-up within 1 year postpartum is an appropriate time to commence preventative strategies, as many women are already showing early signs of disease.
Highlights
Certain complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, intrauterine growth restriction, spontaneous preterm birth, and placental abruption, are established independent risk factors for premature cardiovascular disease in women
The secondary objectives were to explore the presence of socioeconomic, metabolic, and cardiovascular risk factors in this cohort. This was an observational study of women attending the postpartum lifestyle intervention clinic from 7th August 2018 to 30th June 2021 at the Lyell McEwin Hospital, located within the Northern Adelaide Local Health Network (NALHN), South Australia [19]
Ten participants were excluded from the present analysis as they had not completed their biochemistry testing and metabolic syndrome status was unable to be determined
Summary
Certain complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, intrauterine growth restriction, spontaneous preterm birth, and placental abruption, are established independent risk factors for premature cardiovascular disease in women. The Maternal Health Clinic in Ontario, Canada, was introduced in 2011 and is the first postpartum intervention for women with a recent history of complicated pregnancies, inviting eligible women to attend lifestyle education at 6 months postpartum [14] This model has been adopted across a number of sites worldwide in the last decade, and in recent years, a number of research-based postpartum interventions have been developed. The first nurse-led postpartum clinic in Australia was introduced in 2018 at the Lyell McEwin Hospital and aims to provide structured lifestyle and risk education [19] To our knowledge, this is the only published and freely available nurse-led model of care in Australia of standardized, routine, ongoing outpatient care for all eligible women who have experienced a serious complication of pregnancy. In most areas of Australia and the world, there remains little to no attention paid to women in this cohort, despite the recommendations for follow-up in national and international guidelines
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