Key result
Cardiologists lead post-pregnancy cardiovascular risk awareness, though ~85% of all surveyed providers recognize increased risk.
Why the study?
Australian healthcare providers' knowledge of cardiovascular disease risks for women after hypertensive disorders of pregnancy was unknown and needed assessment to guide targeted education.
Cross-Sectional (n=492)
p-value: p=<0.001
Australian healthcare providers, particularly midwives, have significant knowledge gaps regarding specific long-term cardiovascular risks and their onset timing following hypertensive disorders of pregnancy.
Knowledge gaps among midwives and GPs support targeted education; leaves open effects on post-HDP CVD outcomes.
BACKGROUND: Hypertensive disorders of pregnancy (HDP) affect 5-10% of pregnant women. Women after HDP have 2-3 times increased risk of heart attack, stroke and diabetes, as soon as 5-10 years after pregnancy. Australian healthcare providers' knowledge of cardiovascular disease (CVD) risks for women after HDP is unknown, and this study aimed to explore their current knowledge and practice regarding long-term cardiovascular health after HDP, as a precursor to producing targeted healthcare provider education on health after HDP. METHODS: A custom-created, face-validated online survey explored knowledge about long-term risks after HDP. Distribution occurred from February to July 2019 via professional colleges, key organisations and social media. The objective was to assess current knowledge and knowledge gaps amongst a group of healthcare providers (HCP) in Australia, regarding long-term cardiovascular health after hypertensive disorders of pregnancy (HDP), specifically gestational hypertension or preeclampsia. RESULTS: Of 492 respondents, 203 were midwives, 188 obstetricians, 75 general practitioners (GP), and 26 cardiologists. A risk knowledge score was computed with 0-6 considered low, 6.1-8.9 moderate and 9-12 high. Most participants (85%) were aware of increased cardiovascular disease after preeclampsia and gestational hypertension (range 76% midwives to 100% cardiologists). There were significant differences in average knowledge scores regarding health after preeclampsia; high for cardiologists (9.3), moderate for GPs and obstetricians (8.2 and 7.6 respectively) and low for midwives (5.9). Average knowledge scores were somewhat lower for gestational hypertension (9.0 for cardiologists, 7.4 for obstetricians and GPs, 5.1 for midwives). Knowledge was highest regarding risk of chronic hypertension, moderate to high regarding risk of ischaemic heart disease, stroke and recurring HDP, and low for diabetes and peripheral vascular disease. Only 34% were aware that risks start < 10 years after the affected pregnancy. CONCLUSION(S): Participants were aware there is increased cardiovascular risk after HDP, although less aware of risks after gestational hypertension and some specific risks including diabetes. Findings will inform the development of targeted education.
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Roth et al. (2020) conducted a cross-sectional in Knowledge of cardiovascular risk after hypertensive disorders of pregnancy (n=492). Healthcare provider profession (Cardiologists, Obstetricians, GPs, Midwives) was evaluated on Knowledge score regarding long-term health risks after preeclampsia and gestational hypertension (0-12 scale) (p=<0.001). Most healthcare providers (85%) were aware of increased cardiovascular risk after hypertensive disorders of pregnancy, but average knowledge scores varied significantly by profession (cardiologists 9.3, obstetricians 8.2, GPs 7.6, midwives 5.9 for preeclampsia).
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