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Variations in Awareness of Association Between Adverse Pregnancy Outcomes and Cardiovascular Risk by Specialty
Venkata Sai M Gogineni1, Denise Manfrini2, Sharon H Aroda1
1Department of Internal Medicine, University of Florida, Gainesville, FL, USA.
Insights
Physician awareness of the link between adverse pregnancy outcomes (APOs) and future cardiovascular disease (CVD) risk varies by specialty. Many doctors lack knowledge of APOs, like pre-term birth, and proper CVD risk screening in women.
Area of Science:
- Cardiology
- Obstetrics & Gynecology
- Internal Medicine
- Family Medicine
Background:
- Cardiovascular disease (CVD) is the leading cause of death in women.
- Adverse pregnancy outcomes (APOs) like pre-eclampsia (PE), gestational diabetes mellitus (GDM), and pre-term birth (PTB) are linked to future maternal CVD risk.
- Physician awareness of the APO-CVD link and its impact on screening practices is not well understood across specialties.
Purpose of the Study:
- To assess physician awareness of the association between APOs and long-term CVD risk.
- To determine if this awareness differs among physicians in internal medicine, family medicine, obstetrics-gynecology, and cardiology.
Main Methods:
- An anonymous web-based survey was distributed to physicians in internal medicine, family medicine, obstetrics-gynecology, and cardiology.
- The survey assessed knowledge of identifying APOs, their association with future CVD risk, and appropriate CVD risk factor screening in women with APOs.
Main Results:
- Cardiologists demonstrated the highest frequency of screening for APOs.
- Only half of internal medicine and family medicine physicians recognized the APO-CVD association.
- Physicians across specialties identified PE and GDM but not PTB as APOs linked to CVD risk, and many lacked knowledge on screening frequency.
Conclusions:
- Awareness of the APO-CVD link significantly varies by medical specialty.
- A notable proportion of surveyed physicians do not routinely inquire about APOs or identify PTB as a CVD risk factor.
- Targeted education and improved screening protocols for APOs are crucial across all specialties to mitigate maternal CVD morbidity and mortality.
Introduction:
Cardiovascular disease (CVD) remains the leading cause of death among women. Adverse pregnancy outcomes (APOs), including pre-eclampsia (PE), gestational diabetes mellitus (GDM) and pre-term birth (PTB) are associated with future maternal CVD risk. However, data on awareness of the association between APOs and long-term CVD risk among physicians in different specialties are lacking. This study assessed awareness of this association and whether this knowledge varies by specialty.
Methods:
An anonymous web-based voluntary survey was sent to physicians in internal medicine (IM), family medicine (FM), obstetrics-gynecology (Ob-Gyn) and cardiology. The questions aimed to assess a physician's knowledge regarding identification of APOs and their association with future CVD risk and knowledge of CVD risk factor screening in women with APOs and future CVD risk.
Results:
The survey was completed by 53 physicians, of whom 21% were in IM, 26% in FM, 23% in Ob-Gyn and 30% in cardiology. Based on the responses, cardiologists screened most frequently for APOs, with 56% always screening a female patient and 31% often screening. Only half of the IM and FM physicians acknowledged awareness of the association between APOs and CVD risk. Respondents in all specialties recognized PE and GDM as APOs linked to long-term maternal CVD risk, but failed to associate PTB as an APO. The majority of physicians in IM, FM and cardiology also lacked the knowledge of how often to appropriately screen for CVD risk factors associated with APOs.
Conclusion:
Awareness of the association between APO and future maternal CVD risk varies by specialty. A significant percentage of the physicians who responded to the survey did not routinely ask about APOs when assessing CVD risk and failed to identify PTB as a risk factor for APOs. Education on this topic and targeted efforts to improve screening for APOs are needed within all specialties to help reduce CVD morbidity and mortality.
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