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An Enhanced Postpartum Transition Program to Primary Care.

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Summary
This summary is machine-generated.

An enhanced postpartum referral pathway improved primary care clinician (PCP) visits and cardiovascular screenings for individuals with gestational diabetes mellitus (GDM) or hypertensive disorders of pregnancy (HDP). This intervention supports crucial postpartum health monitoring.

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adverse pregnancy outcomescare transitionspostpartum careprimary care

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Area of Science:

  • Obstetrics and Gynecology
  • Cardiovascular Disease Prevention
  • Primary Care Medicine

Background:

  • Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) increase future cardiovascular disease (CVD) risk.
  • Postpartum care transitions to primary care clinicians (PCPs) are often inadequate for these high-risk individuals.
  • Improved postpartum cardiovascular health monitoring is essential for early risk identification and management.

Purpose of the Study:

  • To develop and pilot an enhanced postpartum referral pathway for patients with GDM or HDP.
  • To facilitate timely transitions of care to PCPs within 13 months postpartum.
  • To improve cardiovascular health screening rates in the postpartum period.

Main Methods:

  • A pilot program at an academic medical center implemented an enhanced referral pathway for eligible patients lacking a PCP.
  • Referrals were made by clinicians during antenatal, delivery, or postpartum visits.
  • A dedicated scheduler facilitated appointment booking with women's health-focused PCPs; outcomes compared referred vs. non-referred patients.

Main Results:

  • Of 129 referred individuals, 48.1% attended a PCP visit, 31.8% had cholesterol screening, and 41.9% had HbA1c screening within 13 months.
  • Referred individuals showed significantly higher odds of PCP visits (aOR=6.0), cholesterol screening (aOR=2.4), and HbA1c screening (aOR=2.5) compared to non-referred patients.
  • The enhanced pathway demonstrated a positive association with improved postpartum follow-up and screening.

Conclusions:

  • An enhanced postpartum PCP referral pathway is effective in increasing follow-up care and cardiovascular screenings for high-risk birthing individuals.
  • This intervention supports critical postpartum monitoring for women with GDM or HDP.
  • Implementing such pathways can improve long-term cardiovascular health outcomes in this population.