Miss Jenny He1, Dr Lynne Roberts2,3, Dr Vivian Lee4,5, Mr Damian Kotevski6, Associate Professor Amanda Henry1,2,4, on behalf of the BP2 Steering Committee
1Discipline of Women’s Health, UNSW Medicine and Health, Sydney, Australia, 2Department of Women’s and Children’s Health, St George Hospital, Sydney, Australia, 3St George and Sutherland Clinical Campus, School of Clinical Medicine, UNSW Medicine and Health, Sydney, Australia, 4The George Institute for Global Health, Sydney, Australia, 5Faculty of Medicine, UNSW, Sydney, Australia, 6National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, UNSW, Sydney, Australia
Biography:
Jenny is a dedicated medical student committed to advancing women’s health. She won best undergraduate presentation at St George and Sutherland Research Symposium in 2023 and represented UNSW at the Australia and New Zealand 3MT Competition. Jenny hopes that her obstetrics research will improve long-term outcomes for women globally.
Abstract:
Background and aim: Hypertensive disorders of pregnancy (HDP) and diabetes increase maternal risk of cardiovascular disease postpartum. Women with both HDP and diabetes are at further increased risk. However, early postpartum studies on women with comorbid HDP and diabetes are scarce. This study aimed to compare maternal health from 6- to 12-months postpartum in women with HDP alone versus comorbid diabetes (HDP+D).
Methods: This is a sub-study of the Blood Pressure Postpartum (BP2) randomised controlled trial, a three-arm post-HDP lifestyle intervention study. At 6- and 12-months postpartum, participating women completed questionnaires, underwent blood pressure, weight, and waist circumference measurements, and blood and urine collection. Primary outcomes (systolic blood pressure and composite weight and/or waist circumference change) and secondary lifestyle and cardiometabolic outcomes were compared between HDP alone and HDP+D groups.
Results: Of 382 participants, 81% had HDP alone and 19% HDP+D. Women with HDP+D were older (35.0±5.5 versus 33.6±5.2 years, p=0.052), of higher body mass index (39% ≥30kg/m2 versus 19%, p=0.005), and gave birth earlier (37 versus 38 weeks’ gestation, p=0.012). Both groups had modest (1-2mmHg) reduction in mean systolic blood pressure from 6- to 12-months postpartum, only reaching statistical significance in women with HDP alone (HDP+D p=0.16 versus HDP p=0.013). In HDP+D women, 54% achieved ≥4kg weight loss and/or ≥2cm waist circumference reduction, versus 44% of HDP alone (p=0.13). At 12-months, there were no significant differences in meeting dietary (HDP+D 4% versus HDP 6%, p=0.62) or exercise (68% versus 78%, p=0.072) recommendations.
Conclusions: Women with HDP+D had less favourable cardiometabolic characteristics at 6-months postpartum, which, despite showing improvement from 6- to 12-months postpartum, was not significant in absolute terms or when compared to HDP alone women. Interventions to reduce cardiovascular disease risk in this higher-risk group should be explored.
Keywords
Cardiometabolic health, diabetes, hypertensive disorders of pregnancy