Background:
Cardiovascular disease is the leading cause of death for Australian women, with the burden of premature disease (onset <55 years) increasing. Nationwide, 25% of pregnancies are complicated by disorders associated with an increased risk of future premature cardiovascular disease. These disorders, including hypertension, gestational diabetes, preterm birth, and delivery of a small-for-gestational-age infant, are observed at overwhelming rates at our tertiary care facility in South Australia, with approximately 55% of pregnancies experiencing at least one of these complications. In an Australian first, we have established a postpartum follow-up clinic to reduce cardiovascular risk in women who experience pregnancy complications.
Aims:
This project aims to characterise postpartum cardiovascular risk in our high-risk South Australian population, and to investigate the social determinants of health and their impact on the development of premature heart disease. This project also aims to measure the effectiveness of our intervention at reducing cardiovascular risk in women following pregnancy complications.
Methods:
This prospective study will focus on two local cohorts: women who participated in an observational study during pregnancy but did not receive any intervention if they experienced a pregnancy complication; and women who experience pregnancy complications and were administered an intervention through our ongoing clinical follow-up service. Participants from the first cohort will be invited to attend an appointment for a thorough risk assessment, calculated from a range of biomarker, clinical and haemodynamic tests. Participants from the second cohort will have their data collected from routine care in our dedicated clinic. Social determinants of health will also be recorded in both patient cohorts. Effectiveness of our intervention will be achieved by assessing any reduction in risk 12 months post-intervention.
Conclusion:
To date, our methods and clinical intervention have been trialled in 72 women who experienced a pregnancy complication. Population-specific, structured postpartum intervention after pregnancy complications can reduce the risk of future cardiovascular disease, and ultimately reduce the overall burden of heart disease in women.