Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia

OBJECTIVE: To assess health care providers' knowledge regarding pregnancy outcome as a risk factor for cardiovascular disease and evaluate the variables associated with their responses to questions about routine surveillance for cardiovascular disease. METHODS: A voluntary, anonymous survey of internal medicine and obstetric and gynecologic health care providers at an academic institution. Responses to a case-based and direct inquiry questionnaire were evaluated. RESULTS: The overall response rate was 65% (173/265). When assessing cardiovascular risk, gynecologists compared with internists significantly more often requested a pregnancy history (44/49 90% compared with 56/75 75%, P=.039) and more often attached importance to a history of preeclampsia (35/48 73% compared with 41/75 55%, P=.028). When a history of preeclampsia was obtained, internists more often obtained a fasting glucose test (25/52 48% compared with 9/43 20.9%, P=.009). A minority of health care providers recognized the importance of fetal growth restriction. Both health care provider groups demonstrated similar knowledge of general cardiovascular risk factors, screening tools, and interventions. Higher general cardiovascular knowledge was significantly associated with identification of pregnancy complications as cardiovascular risk factors (P=.001). CONCLUSION: When assessing cardiovascular risk, internists were less likely than gynecologists to include a pregnancy history. However, once identified as at risk for cardiovascular disease, gynecologists were less likely than internists to obtain appropriate testing. Education concerning the link between certain pregnancy complications and future cardiovascular disease is needed. Areas of opportunity for education in both medical specialties are identified.