女性心脏诊所对有既往妊娠并发症女性心血管疾病风险意识的影响：一项前瞻性队列研究。
Impact of a Women's Heart Clinic on Cardiovascular Disease Risk Awareness in Women with Past Pregnancy Complications: A Prospective Cohort Study.
作者信息
Pant Anushriya, Mukherjee Swati, Watts Monique, Marschner Simone, Mishra Shiva, Laranjo Liliana, Chow Clara K, Zaman Sarah
机构信息
Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: https://www.twitter.com/AnushriyaPant.
Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.
出版信息
Heart Lung Circ. 2025 Feb;34(2):153-161. doi: 10.1016/j.hlc.2024.07.017. Epub 2024 Dec 10.
BACKGROUND
Gestational diabetes mellitus (GDM), hypertension during pregnancy (HDP) and/or having small-for-gestational-age (SGA) babies increase cardiovascular disease (CVD) risk. We investigated CVD risk awareness in women with past pregnancy complications and the impact of attending a Women's Heart Clinic (WHC) on this awareness.
METHOD
Women aged 30-55 years with past GDM, HDP and/or SGA babies were prospectively recruited into a 6-month WHC delivering education and management of CVD risk factors (Melbourne, Australia). A nine-item CVD risk Awareness Survey, consisting of six general/three female-specific questions, was administered at baseline and 6-month follow-up. The primary outcome was a change in overall CVD risk awareness before and after attending a WHC, analysed using a McNemar test. Logistic regression assessed for associations between CVD risk awareness and lifestyle behaviours.
RESULTS
A total of 156 women (mean age 41.0±4.2 years, 3.9±2.9 years postpartum) were recruited with 60.3% past GDM, 23.1% HDP, 13.5% both HDP/GDM and 3.2% SGA babies. The majority were White (68.6%), tertiary-educated (79.5%), and from higher income (84.6%). At baseline, 19.2% (95% confidence interval [CI] 13.0%-25.4%) of women had high overall CVD risk awareness, while 63.5% (95% CI 55.9%-71.0%) had high female-specific CVD risk awareness. At 6-month follow-up, overall CVD risk awareness (19.2%-76.1%, p<0.001) and female-specific CVD risk awareness (63.5%-94.8%; p<0.001) significantly increased. Improvement in CVD risk awareness was not associated with higher physical activity (adjusted odds ratio 0.49; 95% CI 0.04-3.21; p=0.51) or heart-healthy diet (adjusted odds ratio 2.49; 95% CI 0.88-6.93; p=0.08) at 6-month follow-up.
CONCLUSIONS
Attendance at a WHC significantly increased women's CVD risk awareness, however, this did not independently associate with lifestyle behaviours.
背景
妊娠期糖尿病（GDM）、妊娠期高血压（HDP）和/或分娩小于胎龄儿（SGA）会增加心血管疾病（CVD）风险。我们调查了有既往妊娠并发症的女性对心血管疾病风险的认知情况，以及参加女性心脏诊所（WHC）对这种认知的影响。
方法
前瞻性招募年龄在30 - 55岁之间、有既往GDM、HDP和/或SGA分娩史的女性，参加为期6个月的女性心脏诊所，该诊所提供心血管疾病风险因素的教育和管理（澳大利亚墨尔本）。在基线和6个月随访时进行一项包含9个项目的心血管疾病风险认知调查，其中包括6个一般问题和3个女性特定问题。主要结局是参加女性心脏诊所前后总体心血管疾病风险认知的变化，采用McNemar检验进行分析。逻辑回归评估心血管疾病风险认知与生活方式行为之间的关联。
结果
共招募了156名女性（平均年龄41.0±4.2岁，产后3.9±2.9年），其中60.3%有既往GDM，23.1%有HDP，13.5%既有HDP/GDM，3.2%有SGA分娩史。大多数为白人（68.6%），接受过高等教育（79.5%），且来自高收入群体（84.6%）。在基线时，19.2%（95%置信区间[CI] 13.0% - 25.4%）的女性有较高的总体心血管疾病风险认知，而63.5%（95% CI 55.9% - 71.0%）的女性有较高的女性特定心血管疾病风险认知。在6个月随访时，总体心血管疾病风险认知（19.2% - 76.1%，p<0.001）和女性特定心血管疾病风险认知（63.5% - 94.8%；p<0.001）显著增加。在6个月随访时，心血管疾病风险认知的改善与更高的身体活动水平（调整后的优势比0.49；95% CI 0.04 - 3.21；p = 0.51）或心脏健康饮食（调整后的优势比2.49；95% CI 0.88 - 6.93；p = 0.08）无关。
结论
参加女性心脏诊所显著提高了女性对心血管疾病风险的认知，然而，这与生活方式行为并无独立关联。
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