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Addressing postpartum contraception practices utilizing a multidisciplinary Pregnancy Heart Team approach
Hayley E Miller1, Samantha C Do1, Giovanna Cruz1
1Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Palo Alto, (Drs Miller, Do, Panelli, Leonard, and Girsen, Ms Lee, and Dr Bianco) CA.
AJOG Global Reports
|December 20, 2022
Summary
People with cardiovascular disease managed by a Pregnancy Heart Team showed improved postpartum contraception planning and uptake compared to low-risk individuals. This highlights the benefit of multidisciplinary care for reducing maternal risks.
Area of Science:
- Reproductive Health
- Cardiology
- Maternal-Fetal Medicine
Background:
- Cardiovascular disease is a leading cause of maternal morbidity and mortality.
- Effective contraception is vital for individuals with cardiovascular disease planning pregnancy.
- Multidisciplinary care models, like Pregnancy Heart Teams, may improve outcomes.
Purpose of the Study:
- To compare postpartum contraceptive practices in individuals with cardiovascular disease (cardiac cohort) managed by a Pregnancy Heart Team against those with other comorbidities (high-risk cohort) and those without (low-risk cohort).
- To assess the influence of the Pregnancy Heart Team on contraception counseling and practices among individuals with cardiovascular disease.
- To evaluate the uptake of reliable postpartum contraception within 8 weeks.
Main Methods:
- Retrospective cohort study comparing three groups: cardiac, high-risk, and low-risk individuals.
- Data collected between 2012-2020 for the cardiac cohort and 2016-2019 for the other cohorts.
- Investigated the presence of a contraceptive plan at admission, discharge, and postpartum visits, and reliable contraception uptake by 8 weeks postpartum.
Main Results:
- The cardiac cohort demonstrated higher odds of reliable postpartum contraception planning and uptake compared to the low-risk cohort.
- Contraceptive planning and uptake were similar between the cardiac cohort and the high-risk cohort.
- Individuals with cardiovascular disease managed by a Pregnancy Heart Team showed improved outcomes compared to the low-risk group.
Conclusions:
- Pregnancy Heart Teams enhance postpartum contraception planning and uptake in individuals with cardiovascular disease.
- Pregnancy offers a critical opportunity for contraception counseling and family planning for those with cardiovascular disease.
- Multidisciplinary team management of postpartum contraception is crucial for reducing maternal morbidity and mortality in this population.
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