Qualitative interviews revealed significant dropout in postpartum cardiovascular risk management during the transition to primary care, especially among ethnic minorities and lower socioeconomic groups.
Postpartum cardiovascular risk management in multi-ethnic populations faces significant barriers, including patient lack of awareness and provider communication issues, highlighting the need for culturally tailored interventions and regional multidisciplinary protocols.
• This study examined experiences and perspectives on postpartum cardiovascular risk management (CVRM) in a multi-ethnic context, to improve care for women at increased cardiovascular risk following hypertensive disorders of pregnancy or gestational diabetes. • Significant dropout was revealed in the CVRM patient journey, particularly during the transition from obstetric to primary care. Ethnic minorities, lower socioeconomic status (SES) groups, and those with lower disease severity were most affected. • Key patient barriers included a lack of awareness of cardiovascular risk, the need to initiate appointments, and expected out-of-pocket costs. Barriers for healthcare professionals included contradicting guidelines with insufficient evidence and poorly structured interdisciplinary communication. • Previously unrecognized barriers for postpartum-CVRM in high-risk, multi-ethnic populations were identified. The need for cultural tailoring to reduce disparities and enhance care is highlighted. Pregnancy complications like gestational diabetes and hypertensive disorders increase maternal cardiovascular risk. However, evidence on how to best implement cardiovascular risk management (CVRM) in multi-ethnic contexts remains limited. Existing studies primarily focus on white populations, despite disparities in CVD risk and the risk of pregnancy complications across ethnic groups. This study explores experiences, barriers, and improvements in postpartum CVRM from women’s and healthcare providers’ perspectives, aiming to enhance cardiovascular disease prevention in multi-ethnic contexts. We conducted semi-structured interviews with 25 postpartum women who experienced hypertensive disorders of pregnancy or gestational diabetes, recruited to reflect diverse ethnic and socioeconomic backgrounds. Using a narrative approach, interviews covered CVRM experiences and preferences. Themes were triangulated with findings from 16 healthcare providers, including general practitioners, midwives, and specialists, discussing care delivery, optimal practices, and multi-ethnic considerations. Results were integrated in a patient journey map. Significant dropout occurred at the transition from obstetric to primary care and during long-term monitoring, especially among ethnic minorities and women with lower socioeconomic status and disease severity. Women often lacked risk awareness and missed follow-ups when self-scheduling was required. Most supported tailored cardiovascular risk education, lifestyle interventions, and proactive outreach. Healthcare providers emphasized the need for interdisciplinary communication, regional protocols, and clearer guidelines, noting variability in general practitioners’ support for routine monitoring. Postpartum CVRM in multi-ethnic contexts could be improved with active outreach, better follow-up utilization, culturally tailored interventions, and regional multidisciplinary protocols to streamline care and address guideline inconsistencies.
Reilingh et al. (Thu,) conducted a other in Hypertensive disorders of pregnancy or gestational diabetes (n=41). Postpartum cardiovascular risk management was evaluated on Experiences, barriers, and improvements in postpartum CVRM. Qualitative interviews revealed significant dropout in postpartum cardiovascular risk management during the transition to primary care, especially among ethnic minorities and lower socioeconomic groups.