What Is My Risk? A Mixed-Methods Systematic Review of Risk Perception for Cardiometabolic Pregnancy Complications and...

Cardiometabolic pregnancy complications increase future cardiometabolic disease risk. Accurate risk perception plays a central role in adopting risk-reducing lifestyle and health-related behaviors, such as healthy eating, physical activity, and weight management. This review aimed to explore high-risk pregnant and postpartum women's perception of their risk of developing cardiometabolic pregnancy complications or future cardiometabolic disease.

Systematic search identified quantitative and qualitative data exploring risk perception in women (pregnant/postpartum) at risk of or diagnosed with gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), intrauterine growth restriction (IUGR), and preterm birth (PTB). A convergent integrated mixed-methods synthesis was undertaken, with findings interpreted using the health belief and capability, opportunity, and motivation for behavior change models.

Overall, 84 studies were included, with the majority in GDM (77.4%) and HDP (23.8%), with limited research in PTB (8.3%) and IUGR (6.0%). Women had low-moderate knowledge of pregnancy complications as risk factors for future cardiometabolic disease and low-moderate perceived susceptibility to potential pregnancy complications and future cardiometabolic disease. Self-perceived barriers, facilitators, cues to action, self-efficacy, and self-optimism impacted engagement with lifestyle and screening measures. The highest risk perception for future type 2 diabetes or cardiovascular disease was among women who had previously experienced GDM or HDP, respectively.

Designing interventions to optimize women's risk perception will support informed decision-making and empower women to make lifestyle changes to reduce future cardiometabolic risk.