Dr Djamila Ait Ouarab1, Dr Anne-Marie Côté2, Dr Annabelle Cumyn3, Dr Myriam Champagne4, Dr Marie-Hélène Pesant5, Mrs Mandy Malick1, Dr Marie-Ève Roy-Lacroix6, Dr Nadine Sauvé3
1Department of Medicine, University Of Sherbrooke, Sherbrooke, Canada, 2Division of Nephrology and Obstetric Medicine, University of Sherbrooke, Sherbrooke, Canada, 3Division of Internal Medicine and Obstetric Medicine, University of Sherbrooke, Sherbrooke, Canada, 4Division of Perinatality, Department of Family Medicine, University of Sherbrooke, Sherbrooke, Canada, 5Division of Endocrinology, University of Sherbrooke, Sherbrooke, Canada, 6Department of Obstetrics-Gynecology, University of Sherbrooke, Sherbrooke, Canada
Biography:
Obstetric Medicine physician for over 20 years, Dr. Sauvé founded the Obstetric Medicine Division at her tertiary care center in 2002 after her fellowhip at Women & Infants Hospital in Providence, RI. She is very active in the field, being past president of NASOM and the current president of GÉMOQ.
Abstract:
Background: Hypertensive disorders of pregnancy (HDP) are well recognized risk factors for cardiovascular diseases (CVD). Since most risk factors associated with HDP and CVD are modifiable and new mothers are receptive to lifestyle changes, we created a postpartum clinic to assess future risks, offer counseling about lifestyle, and inform primary care providers (PCP). The objectives of the study were to evaluate attendance to postpartum clinic and to follow-up visits, the effects of the interventions on lifestyle, and the satisfaction about the clinic.
Method: This is a prospective, observational, pilot study at the Centre Hospitalier Universitaire de Sherbrooke (CHUS). All referrals were followed and attendance to the clinic recorded. Participants were recruited at their first visit to the Clinique Santé Globale Postpartum (CSGPP). A questionnaire was filled out about past medical and obstetric history, lifestyle, and motivation. A final questionnaire (Q2) was sent one year postpartum assessing follow-up visits, lifestyle, motivation and satisfaction. A convenience sample of 30 participants having completed Q2 was planned.
Results: During the first year of the CSGPP, 84 of the 104 women referred attended their first visit at 3 months (80.8%). Of those, 65 were recruited for the study and 47 completed the study protocol. Only 67.7% of our high risk participants had at least one follow-up with their PCP. Although we were not able to detect significant changes in lifestyle, conviction that lifestyle changes can improve future health increased significantly between 3 and 12 months (8.8 vs. 9.3/10, p=007). The CSGPP was ranked the highest among different sources of information (8.2/10) and for satisfaction (8.5/10).
Conclusion: The adherence at the first visit to the CSGPP is excellent and results of satisfaction justifies the continuation of the clinic. Larger cohorts are needed to determine if lifestyle changes are achieved with those interventions.
Keywords
Hypertensive disorders of pregnancy
Postpartum cardiovascular clinic
Cardiovascular risk assessment
References
1. Newstead J., Von Dadelszen P, Magee L. Preeclampsia and Future Cardiovascular Risk. Expert Review of Cardiovascular Therapy 5; 2 (2007): 283–94.
2. Smith, GN., Pudwell J, and Roddy M. The Maternal Health Clinic: A New Window of Opportunity for Early Heart Disease Risk Screening and Intervention for Women with Pregnancy Complications. JOGC 35; 9 (2013): 831–39.
3. Janmohamed R, Montgomery-Fajic E, Sia W, et al. Cardiovascular Risk Reduction and Weight Management at a Hospital-Based Postpartum Preeclampsia Clinic. JOGC 37; 4 (2015): 330–37.