Mattocks Kristin M, Shenette Lisa L, Goldstein Karen, Bean-Mayberry Bevanne, Maher Nancy, Haskell Sally
VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA.
University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
J Womens Health (Larchmt). 2025 Mar;34(3):e433-e440. doi: 10.1089/jwh.2024.0618. Epub 2024 Oct 8.
Women veterans who experience certain conditions during pregnancy, such as gestational hypertension, pre-eclampsia, and gestational diabetes, are at increased risk of developing cardiovascular disease (CVD) later in life. Many women are unaware of this risk. Furthermore, women often face financial, socioeconomic, or physical challenges when trying to make healthy behavior modifications to reduce CVD risk. To examine Veterans' pregnancy-related cardiovascular (CV) risk conditions, risk identification, and risk communication with primary care providers. Telephone/video interviews were conducted with female Veterans who had experienced at least one sex-specific CV risk condition during pregnancy. Interviews were recorded, transcribed, and analyzed using content analysis techniques. Major themes and representative quotes were derived. Twenty-eight women Veterans participated in the study, conducted between October and December 2023. A majority of participants were racial/ethnic minorities, and the average age was 38. Four themes arose: (1) Veterans Affairs (VA) medical records may contain limited information regarding CV risk factors experienced during pregnancy; (2) strong relationships between Veterans and their VA primary care providers can facilitate management of CV risk factors following pregnancy; (3) some Veterans receive vague and/or conflicting recommendations for CV risk reduction following pregnancy; and (4) social determinants of health may play a key role in Veterans' ability to follow recommended CV risk reduction behaviors. Women Veterans with pregnancy-related CV risk conditions may not know that they are at increased risk of developing future CVD conditions, often because VA providers receive limited records from outside providers. Those who are aware often receive conflicting or vague recommendations to address these risk factors. When trying to follow CV health recommendations, many women have difficulty due to lack of finances, childcare, or safe areas. Future interventions should be aimed at improving access to medical records between outside and VA providers, patient education, and access to heart-healthy resources.
经历过某些孕期状况（如妊娠期高血压、先兆子痫和妊娠糖尿病）的退伍女兵，日后患心血管疾病（CVD）的风险会增加。许多女性并未意识到这种风险。此外，女性在尝试做出健康行为改变以降低心血管疾病风险时，往往面临经济、社会经济或身体方面的挑战。为了研究退伍军人与妊娠相关的心血管（CV）风险状况、风险识别以及与初级保健提供者的风险沟通情况。对在孕期经历过至少一种特定性别的心血管风险状况的女性退伍军人进行了电话/视频访谈。访谈进行了录音、转录，并使用内容分析技术进行分析。得出了主要主题和代表性引语。28名女性退伍军人参与了这项于2023年10月至12月期间开展的研究。大多数参与者是少数族裔，平均年龄为38岁。出现了四个主题：（1）退伍军人事务部（VA）的医疗记录可能包含关于孕期经历的心血管风险因素的有限信息；（2）退伍军人与其VA初级保健提供者之间的牢固关系有助于孕期后心血管风险因素的管理；（3）一些退伍军人在孕期后收到关于降低心血管风险的模糊和/或相互矛盾的建议；（4）健康的社会决定因素可能在退伍军人遵循推荐的心血管风险降低行为的能力方面发挥关键作用。患有与妊娠相关的心血管风险状况的女性退伍军人可能不知道她们未来患心血管疾病的风险增加，这通常是因为VA提供者从外部提供者那里收到的记录有限。那些意识到这一点的人往往会收到相互矛盾或模糊的建议来应对这些风险因素。在尝试遵循心血管健康建议时，许多女性由于缺乏资金、儿童保育或安全区域而遇到困难。未来的干预措施应旨在改善外部提供者与VA提供者之间的医疗记录获取、患者教育以及获得心脏健康资源的机会。
