Healthcare providers' awareness and management of cardiovascular risks in women with hypertensive disorders of pregnancy and gestational diabetes

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of death and the mortality rate and prognosis of CVD in women are worse compared to men. Adverse Pregnancy Outcomes (APOs) are frequently overlooked sex-specific risk factors for CVD and affect up to one in five pregnant women. This study evaluated healthcare providers'(HCPs) awareness of the long-term cardiovascular risk associated with gestational diabetes mellitus and hypertensive disorders of pregnancy.

METHODS: A cross-sectional survey was conducted in Austria between March and August 2022 to assess HCPs' knowledge, follow-up recommendations, and counseling regarding cardiovascular risk following APOs. The respondents were divided into general medicine, Obstetrics and Gynecology (O&G), general internal medicine, and cardiology.

RESULTS: Of the 175 responses, 20% (n = 35) were from general medicine, 39% (n = 68) from O&G, 39% (n = 69) from general internal medicine and cardiology, and 2% (n = 3) from other specialties. Although most respondents were aware of increased CVD risk following APOs, significant knowledge gaps were identified, particularly concerning the prevalence and timing of CVD onset after APOs. Over 50% do not counsel women with APOs on cardiovascular risk reduction strategies and approximately half do not counsel on the risk of recurrence of APOs. Less than 20% provide women with written follow-up information. Differences in expertise were observed among specialties, with O&G demonstrating the highest level of knowledge.

CONCLUSION: This study identified knowledge gaps among HCPs in postpartum care for women with APOs highlighting the importance of standardized follow-up programs and the need for targeted education for HCPs.