Many women are not being counseled about heart disease after giving birth, a new study finds.
Only 60% of at-risk women said they were advised about heart health at their postpartum checkup, researchers say.
About 90% of U.S. women have a doctor visit during what is referred to as the “fourth trimester.”
“We need to find ways to take advantage of this prime opportunity when we have a captive audience of people who are already in the doctor’s office, talking about their health at a critical juncture in life,” said researcher Dr. Sadiya Khan, an assistant professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine.
“It is hard to create new opportunities. The fourth-trimester visit is an already-ready moment to prioritize maternal heart health,” she said in a university news release.
Counseling on heart health includes healthy eating, exercise and losing weight gained during pregnancy.
Researchers said their study is the first to quantify rates of postpartum heart health counseling for women who have heart disease risk factors or who experienced pregnancy complications.
They found that between 2016 and 2020, the frequency of heart disease risk factors, such as being overweight, having diabetes or high blood pressure and delivering preterm, rose.
“Our data show that reports of overall counseling are low. For people who have risk factors, lifestyle counseling during this critical time is a first step to reducing long-term risk of heart disease,” said study co-author Dr. Natalie Cameron, an instructor of general internal medicine at Northwestern.
“While the postpartum visit represents an opportunity to reach a large number of women, it is only the start,” she said in the release. “Health care systems must improve continuity of care after pregnancy and help women find clinicians who can provide preventive care. These can be obstetricians-gynecologists, primary care clinicians or cardiologists, depending on the patient’s needs and the clinician’s expertise.”
More women may have received counseling, but only 60% remembered they received counseling, Khan said.
“If counseling is provided but they don’t remember it or it does not translate into improvements in heart health, it’s not very effective,” Khan said, urging identification of counseling strategies to improve heart health in the first year after pregnancy.
Systems and policies must support the transition from pregnancy to postpartum and ensure women can get care throughout the first year and beyond. Cameron said expanding postpartum Medicaid coverage from 60 days to 12 months would improve access to care for the more than 40% of U.S. women insured by Medicaid during pregnancy.
“In the midst of the growing public health crisis around maternal health, we also need to continue to increase awareness of the importance of long-term cardiovascular health monitoring and optimization among women with adverse pregnancy outcomes,” Cameron said.
The study was published July 25 in the Journal of the American Medical Association.
For more on women’s heart health, visit the American Heart Association.
SOURCE: Northwestern University, news release, July 25, 2023
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