Cardiovascular Health After Preeclampsia: Patient and Provider Perspective

Published on Mar 4, 2021in Journal of Womens Health1.933
· DOI :10.1089/JWH.2020.8384
Ellen W. Seely62
Estimated H-index: 62
(Harvard University),
Ann C. Celi6
Estimated H-index: 6
(Harvard University)
+ 10 AuthorsJanet W. Rich-Edwards103
Estimated H-index: 103
(Harvard University)
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Abstract
Background: Preeclampsia predicts future cardiovascular disease (CVD) yet few programs exist for post-preeclampsia care. Methods: The Health after Preeclampsia Patient and Provider Engagement Network workshop was convened at the Radcliffe Institute for Advanced Study in June 2018. The workshop sought to identify: 1) patient perspectives on barriers and facilitators to CVD risk reduction; 2) clinical programs specialized in post-preeclampsia care; 3) recommendations by national organizations for risk reduction; and 4) next steps. Stakeholders included the Preeclampsia Foundation, patients, clinicians who had initiated CVD risk reduction programs for women with prior preeclampsia, researchers, and national task force members. Results: Participants agreed there is insufficient awareness and action to prevent CVD after preeclampsia. Patients suggested a clinician checklist to ensure communication of CVD risks, enhanced training for clinicians on the link between preeclampsia and CVD, and a post-delivery appointment with a clinician knowledgeable about this link. Clinical programs primarily served patients in the first postpartum year, bridging obstetrical and primary care. They recommended CVD risk modification with periodic blood pressure, weight, lipid and diabetes screening. Barriers included the paucity of programs designed for this population and gaps in insurance coverage after delivery. The American Heart Association, the American College of Obstetricians and Gynecologists, and the Preeclampsia Foundation have developed guidelines and materials for patients and providers to guide management of women with prior preeclampsia. Conclusions: Integrated efforts of patients, caregivers, researchers, and national organizations are needed to improve CVD prevention after preeclampsia. This meeting's recommendations can serve as a resource and catalyst for this effort.
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#1Lois McCloskey (BU: Boston University)H-Index: 15
#2Judith Bernstein (BU: Boston University)H-Index: 28
Last. Christina LachanceH-Index: 1
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Abstract Background Many pregnant people find no bridge to ongoing specialty or primary care after delivery, even when clinical and social complications of pregnancy signal need. Black, indigenous and all other women of color are especially harmed by fragmented care and access disparities, coupled with impacts of racism over the life course and in health care. Methods We launched the initiative “Bridging the Chasm between Pregnancy and Health across the Life Course” in 2018, bringing together pa...
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#1Lois McCloskey (BU: Boston University)H-Index: 15
#2Ndidiamaka N. Amutah-Onukagha (Tufts University)H-Index: 4
Last. Arden Handler (UIUC: University of Illinois at Urbana–Champaign)H-Index: 31
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Background COVID-19 exposes major gaps in the MCH safety net and illuminates the disproportionate consequences borne by people living in low resource communities where systemic racism, community disinvestment, and social marginalization creates a perfect storm of vulnerability. Methods We draw eight lessons from the first 8 months of the pandemic, describing how COVID-19 has intensified pre-existing gaps in the MCH support network and created new problems. For each lesson identified, we present ...
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