Queen's University Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston, ON.
Queen's University Department of Obstetrics and Gynaecology, Kingston General Hospital, Kingston, ON.
J Obstet Gynaecol Can. 2024 Aug;46(8):102580. doi: 10.1016/j.jogc.2024.102580. Epub 2024 Jun 6.
The postpartum Maternal Health Clinic (MHC) sees patients who have experienced pregnancy complications identified as pregnancy-related cardiovascular disease (CVD) risk indicators (hypertensive disorders of pregnancy, gestational diabetes, placental abruption, idiopathic preterm delivery, and intrauterine growth restriction) at 6 months postpartum for CVD risk screening. This project aimed to summarise the past 10 years of the MHC and identify trends in patient characteristics, patient CVD risk assessments, and clinic attendance over time.
Patients included in this study have experienced 1 or more pregnancy-related CVD risk indicator(s) and have delivered between April 2011 and April 2021. MHC patient data and the Better Outcomes Registry Network database were utilised to compare eligible and participating patient data during clinically significant time periods.
The clinic has seen 1030 patients in the last 10 years and their characteristics have remained largely consistent. However, there has been an increase in the proportion of patients seen because of a hypertensive disorder and an increase in the proportion of patients with obesity, abnormal total cholesterol, and elevated fasting glucose. Additionally, CVD risk scores and the prevalence of metabolic syndrome have remained consistent over the years. Regarding the clinic's outreach, patient eligibility for the MHC has been increasing while attendance has been decreasing over time.
Overall, there remains a need to screen these patients for CVD risk and counsel them on risk reduction. There is also an opportunity to increase patient recruitment to improve attendance and to address the increased need for CVD risk screening and counselling in the community.
产后母婴健康诊所(MHC)为产后 6 个月的患者提供心血管疾病(CVD)风险筛查服务,这些患者曾经历过妊娠并发症,被认为是妊娠相关 CVD 风险指标(妊娠高血压疾病、妊娠期糖尿病、胎盘早剥、特发性早产和宫内生长受限)。本项目旨在总结过去 10 年 MHC 的情况,确定患者特征、患者 CVD 风险评估以及随时间推移的就诊趋势。
本研究纳入了曾经历过 1 种或多种妊娠相关 CVD 风险指标且在 2011 年 4 月至 2021 年 4 月间分娩的患者。利用 MHC 患者数据和 Better Outcomes Registry Network 数据库,比较了在临床重要时间段内符合条件的患者数据和参与患者数据。
在过去的 10 年中,该诊所共接待了 1030 名患者,其特征基本保持不变。然而,因高血压疾病就诊的患者比例有所增加,肥胖、总胆固醇异常和空腹血糖升高的患者比例也有所增加。此外,CVD 风险评分和代谢综合征的患病率多年来一直保持稳定。就该诊所的外展情况而言,患者有资格参加 MHC 的比例一直在增加,而就诊率却随时间下降。
总体而言,仍需要对这些患者进行 CVD 风险筛查,并就降低风险向他们提供咨询。还可以增加患者招募,以提高就诊率,并解决社区中对 CVD 风险筛查和咨询的需求增加的问题。