在产后患者心血管健康咨询的趋势
Natalie A Cameron1, Lynn M Yee2, Brigid M Dolan1
1Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Northwestern University, Chicago, Illinois.
JAMA
|July 25, 2023
概括
从2016年至2020年间,产后诊所对心血管健康 (CVH) 的咨询略有下降. 尽管如此,患有心血管疾病 (CVD) 风险因素的人更有可能接受咨询.
科学领域:
- 心血管健康
- 公共卫生
- 生殖健康
背景情况:
- 怀孕前心血管健康不佳是导致怀孕不良结果和未来患心血管疾病的重要危险因素.
- 产后访问是解决和改善现有风险因素的个体的关键机会.
研究的目的:
- 确定产后诊断期间自我报告的心血管健康 (CVH) 咨询的流行率,预测因素和趋势.
- 分析怀孕前心血管疾病 (CVD) 风险因素和不良妊娠结果 (APOs) 的不同人群中CVH咨询的趋势.
主要方法:
- 从2016年至2020年的怀孕风险评估监测系统 (PRAMS) 的数据进行了连续的横截面分析.
- 包括参加产后诊所的个体 (N=167705),分析自我报告的CVH咨询,孕前心血管疾病风险因素 (肥胖,糖尿病,高血压) 和APO (妊娠糖尿病,妊娠高血压疾病,早产).
主要成果:
- 自我报告的产后CVH咨询的患病率从2016年至2020年间在所有群体中略有下降,包括没有,一个或两个或更多心血管疾病风险因素的群体.
- 与没有风险因素的人相比,具有一个或多个心血管疾病风险因素或APO的人更有可能报告接受CVH咨询.
- 平均每年百分比变化 (APC) 显示,在研究期间,辅导患病率持续下降,尽管很小.
结论:
- 虽然大约60%的患有心血管疾病风险因素或APO的人报告接受了CVH咨询,但这种咨询的总体患病率在2016年至2020年之间略有下降.
- 这些发现突显出危险人群在关键的产后期接受CVH咨询的情况有所下降.
- 需要进一步的研究和干预,以确保对所有生育成年人,特别是那些有先前存在的风险因素的人提供一致和有效的CVH咨询.
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