Provider Counseling About and Risk Perception for Future Chronic Disease Among Women with Gestational Diabetes and Preeclampsia.
Provider Counseling About and Risk Perception for Future Chronic Disease Among Women with Gestational Diabetes and Preeclampsia.
复制标题
DOI：
10.1089/jwh.2019.7767
复制
发表时间：
2020-05
期刊：
影响因子：
--
通讯作者：
Lauren Sutherland;D. Neale;J. Henderson;J. Clark;D. Levine;W. Bennett
中科院分区：
文献类型：
--
作者：
Lauren Sutherland;D. Neale;J. Henderson;J. Clark;D. Levine;W. Bennett
背景：被诊断患有妊娠糖尿病或先兆子痫的女性未来患 2 型糖尿病、高血压和心血管疾病的风险更大。对未来慢性病风险的认识增强与健康行为的改变呈正相关，包括孕妇。尽管妊娠期糖尿病是 2 型糖尿病的危险因素，但很少有女性有较高的风险认知。很少有研究评估先兆子痫女性接受医疗服务提供者提供的健康建议及其与未来高血压和心血管疾病风险认知的关系。在最近诊断出先兆子痫或妊娠糖尿病的女性中，我们评估了接受医疗服务提供者提供的健康建议、心理社会因素以及妊娠并发症类型与未来慢性病风险认知之间的关联。方法：我们通过产后和产后 3 个月的调查和病历摘要，对 79 名被诊断患有先兆子痫和/或妊娠糖尿病的女性进行了横断面分析。结果：总体而言，79 名患有先兆子痫和妊娠糖尿病的女性中，只有不到一半的人表示接受过医疗服务提供者的健康建议，而且与患有妊娠糖尿病的女性相比，患有先兆子痫的女性接受咨询的可能性显着较低（比值比 0.23）。我们没有发现妊娠并发症或接受健康建议对风险认知程度的差异。年龄、种族、教育程度或健康保险覆盖范围的风险认知没有显着差异。结论：我们证明，患有先兆子痫和妊娠糖尿病的女性不会定期从医疗服务提供者处获得有关未来慢性病风险的健康建议，并且与患有妊娠糖尿病的女性相比，患有先兆子痫的女性不太可能获得有关其风险的咨询。需要以提供者和患者为中心的干预措施，以改善基于近期妊娠并发症的慢性病高危妇女的产后护理和咨询。
Background: Women diagnosed with gestational diabetes or preeclampsia are at a greater risk of developing future type 2 diabetes mellitus, high blood pressure, and cardiovascular disease. Increased perception of future chronic disease risk is positively associated with making health behavior changes, including in pregnant women. Although gestational diabetes is a risk factor for type 2 diabetes, few women have heightened risk perception. Little research has assessed receipt of health advice from a provider among women with preeclampsia and its association with risk perception regarding future risk of high blood pressure and cardiovascular disease. Among women with recent diagnoses of preeclampsia or gestational diabetes, we assessed associations between receipt of health advice from providers, psychosocial factors, and type of pregnancy complication with risk perception for future chronic illness. Methods: We conducted a cross-sectional analysis among 79 women diagnosed with preeclampsia and/or gestational diabetes using surveys and medical record abstraction after delivery and at 3 months postpartum. Results: Overall, fewer than half of the 79 women with preeclampsia and gestational diabetes reported receiving health advice from a provider, and women with preeclampsia were significantly less likely to receive counseling as compared with women with gestational diabetes (odds ratio 0.23). We did not identify a difference in the degree of risk perception by pregnancy complication or receipt of health advice. There were no significant differences in risk perception based on age, race, education, or health insurance coverage. Conclusions: We demonstrated that women with preeclampsia and gestational diabetes are not routinely receiving health advice from providers regarding future chronic disease risk, and that women with preeclampsia are less likely to be counseled on their risk, compared with women with gestational diabetes. Provider and patient-centered interventions are needed to improve postpartum care and counseling for women at high risk for chronic disease based on recent pregnancy complications.