Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia
Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia
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DOI：
10.1097/aog.0000000000000856
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发表时间：
2015-06-01
影响因子：
7.2
通讯作者：
Seely, Ellen W.
中科院分区：
文献类型：
--
作者：
Wilkins-Haug, Louise;Celi, Ann;Seely, Ellen W.
目的：为了评估医疗保健提供者的知识，妊娠结局作为心血管疾病的危险因素，并评估与他们的反应有关的问题，常规监测心血管疾病.METHODS：一个自愿的，匿名的调查内科和妇产科医疗保健提供者在学术机构的变量。对基于病例和直接询问问卷的反应进行了评估。结果：总体应答率为65%（173/265）。在评估心血管风险时，与内科医生相比，妇科医生更经常要求妊娠史（44/49 [90%]与56/75 [75%]相比，P=.039），更经常重视先兆子痫史（35/48 [73%]与41/75 [55%]相比，P=.028）。当有先兆子痫病史时，内科医生更常进行空腹血糖检测（25/52 [48%]与9/43 [20.9%]相比，P= 0.009）。少数卫生保健提供者认识到胎儿生长限制的重要性。两个医疗保健提供者组表现出类似的知识，一般心血管危险因素，筛查工具和干预措施。较高的心血管知识与妊娠并发症作为心血管危险因素的识别显著相关（P= 0.001）。结论：在评估心血管风险时，内科医生不太可能比妇科医生包括妊娠史。然而，一旦被确定为心血管疾病的风险，妇科医生不太可能比内科医生获得适当的测试。需要就某些妊娠并发症与未来心血管疾病之间的联系进行教育。确定了两个医学专业的教育机会领域。
OBJECTIVE: To assess health care providers' knowledge regarding pregnancy outcome as a risk factor for cardiovascular disease and evaluate the variables associated with their responses to questions about routine surveillance for cardiovascular disease.METHODS: A voluntary, anonymous survey of internal medicine and obstetric and gynecologic health care providers at an academic institution. Responses to a case-based and direct inquiry questionnaire were evaluated.RESULTS: The overall response rate was 65% (173/265). When assessing cardiovascular risk, gynecologists compared with internists significantly more often requested a pregnancy history (44/49 [90%] compared with 56/75 [75%], P=.039) and more often attached importance to a history of preeclampsia (35/48 [73%] compared with 41/75 [55%], P=.028). When a history of preeclampsia was obtained, internists more often obtained a fasting glucose test (25/52 [48%] compared with 9/43 [20.9%], P=.009). A minority of health care providers recognized the importance of fetal growth restriction. Both health care provider groups demonstrated similar knowledge of general cardiovascular risk factors, screening tools, and interventions. Higher general cardiovascular knowledge was significantly associated with identification of pregnancy complications as cardiovascular risk factors (P=.001).CONCLUSION: When assessing cardiovascular risk, internists were less likely than gynecologists to include a pregnancy history. However, once identified as at risk for cardiovascular disease, gynecologists were less likely than internists to obtain appropriate testing. Education concerning the link between certain pregnancy complications and future cardiovascular disease is needed. Areas of opportunity for education in both medical specialties are identified.