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有生育能力的孕妇及绝经后女性的生殖经历与心血管疾病护理:来自美国心脏协会“红丝带研究”登记处的见解

Reproductive Experiences and Cardiovascular Disease Care in Pregnancy Capable and Post-Menopausal Individuals: Insights from the American Heart Association Research Goes Red Registry.

作者信息

Rao Shiavax J, Kwapong Yaa A, Boakye Ellen, Mallya Pratheek, Zhao Juan, Akel William, Hong Haoyun, Li Shen, Oyeka Chigolum P, Metlock Faith Elise, Ouyang Pamela, Blumenthal Roger S, Nasir Khurram, Khandelwal Abha, Kinzy Claire, Mehta Laxmi S, Roger Veronique L, Hall Jennifer L, Sharma Garima

出版信息

medRxiv. 2023 Mar 15:2023.03.14.23287279. doi: 10.1101/2023.03.14.23287279.

Abstract

BACKGROUND

Information on reproductive experiences and awareness of adverse pregnancy outcomes (APOs) and cardiovascular disease (CVD) risk among pregnancy-capable and post-menopausal individuals has not been well described. We sought to evaluate preconception health and APO awareness in a large population-based registry.

METHODS

Data from the Fertility and Pregnancy Survey of the American Heart Association Research Goes Red Registry (AHA-RGR) were used. Responses to questions pertaining to prenatal health care experiences, postpartum health, and awareness of the association of APOs with CVD risk were used. We summarized responses using proportions for the overall sample and by stratifications, and we tested differences using the Chi-squared test.

RESULTS

Of 4,651individuals in the AHA-RGR registry, 3,176 were of reproductive age, and 1,475 were postmenopausal. Among postmenopausal individuals, 37% were unaware that APOs were associated with long-term CVD risk. This varied by different racial/ethnic groups (non-Hispanic White: 38%, non-Hispanic Black: 29%, Asian: 18%, Hispanic: 41%, Other: 46%; = 0.03). Fifty-nine percent of the participants were not educated regarding the association of APOs with long-term CVD risk by their providers. Thirty percent of the participants reported that their providers did not assess pregnancy history during current visits; this varied by race-ethnicity ( = 0.02), income ( = 0.01), and access to care ( = 0.02). Only 37.1% of the respondents were aware that CVD was the leading cause of maternal mortality.

CONCLUSIONS

Considerable knowledge gaps exist in the association of APOs with CVD risk, with disparities by race/ethnicity, and most patients are not educated on this association by their health care professionals. There is an urgent and ongoing need for more education on APOs and CVD risk, to improve the health-care experiences and postpartum health outcomes of pregnant individuals.

摘要

背景

关于有生育能力的个体和绝经后个体的生殖经历、不良妊娠结局(APO)意识以及心血管疾病(CVD)风险的信息尚未得到充分描述。我们试图在一个大型的基于人群的登记系统中评估孕前健康状况和APO意识。

方法

使用了美国心脏协会“研究走向红色”登记系统(AHA - RGR)的生育与妊娠调查数据。对有关产前保健经历、产后健康以及APO与CVD风险关联意识的问题的回答进行了分析。我们使用总体样本和分层的比例来总结回答,并使用卡方检验来检验差异。

结果

在AHA - RGR登记系统的4651名个体中,3176名处于育龄期,1475名已绝经。在绝经后个体中,37%的人不知道APO与长期CVD风险有关。这在不同种族/族裔群体中有所不同(非西班牙裔白人:38%,非西班牙裔黑人:29%,亚洲人:18%,西班牙裔:41%,其他:46%;P = 0.03)。59%的参与者未从其医疗服务提供者处得到关于APO与长期CVD风险关联的教育。30%的参与者报告称其医疗服务提供者在当前就诊时未评估妊娠史;这在种族/族裔(P = 0.02)、收入(P = 0.01)和就医机会(P = 0.02)方面存在差异。只有37.1%的受访者知道CVD是孕产妇死亡的主要原因。

结论

APO与CVD风险的关联存在相当大的知识差距,且因种族/族裔而异,大多数患者未从其医疗保健专业人员处得到关于这种关联的教育。迫切需要持续加强关于APO和CVD风险的教育,以改善孕妇的医疗保健经历和产后健康结局。

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