Pre-eclampsia and future cardiovascular disease risk: Assessing British clinicians' knowledge and practice

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Public Health

Background:

• Pre-eclampsia is a significant risk factor for long-term cardiovascular disease (CVD).
• Understanding UK clinicians' awareness and management of these risks is crucial for preventative care.
• Current practices may not adequately address the heightened CVD risk post-pre-eclampsia.

Purpose of the Study:

• To assess UK clinicians' knowledge regarding long-term cardiovascular disease risks following pre-eclampsia.
• To evaluate current clinical practices for managing cardiovascular risk in women with a history of pre-eclampsia.
• To identify gaps in education and practice for improved patient outcomes.

Main Methods:

• A voluntary online survey was distributed to UK clinicians (midwives, obstetricians, cardiologists, GPs) from May to July 2022.
• The survey explored awareness of pre-eclampsia's link to future CVD, knowledge of guidelines, and counselling practices.
• Descriptive analysis was used to interpret the collected data.

Main Results:

• Most clinicians recognized pre-eclampsia's association with chronic hypertension (89%) and stroke (75%), but awareness of heart failure (47%) and peripheral vascular disease (55%) was lower.
• Obstetricians were most likely to counsel patients (43% always, 27% often), while midwives (76%), cardiologists (75%), and GPs (62%) rarely did.
• A significant majority (84%) were unaware of specific CVD risk management guidance, and 75% of cardiologists and GPs did not consider pre-eclampsia in risk assessments.

Conclusions:

• This study highlights a critical gap in UK clinicians' knowledge and practice regarding postpartum cardiovascular risk after pre-eclampsia.
• Despite awareness of some risks, patient counselling and guideline adherence are limited, particularly among non-obstetric specialists.
• Targeted educational interventions are essential to improve clinician knowledge and practice, ultimately aiming to reduce the long-term cardiovascular disease burden in women affected by pre-eclampsia.