Impact of a Women's Heart Clinic on Cardiovascular Disease Risk Awareness in Women with Past Pregnancy Complications: A Prospective Cohort Study

Background: Gestational diabetes mellitus (GDM), hypertension during pregnancy (HDP) and/or having small-for-gestational-age (SGA) babies increase cardiovascular disease (CVD) risk. We investigated CVD risk awareness in women with past pregnancy complications and the impact of attending a Women's Heart Clinic (WHC) on this awareness. Method: Women aged 30–55 years with past GDM, HDP and/or SGA babies were prospectively recruited into a 6-month WHC delivering education and management of CVD risk factors (Melbourne, Australia). A nine-item CVD risk Awareness Survey, consisting of six general/three female-specific questions, was administered at baseline and 6-month follow-up. The primary outcome was a change in overall CVD risk awareness before and after attending a WHC, analysed using a McNemar test. Logistic regression assessed for associations between CVD risk awareness and lifestyle behaviours. Results: A total of 156 women (mean age 41.0±4.2 years, 3.9±2.9 years postpartum) were recruited with 60.3% past GDM, 23.1% HDP, 13.5% both HDP/GDM and 3.2% SGA babies. The majority were White (68.6%), tertiary-educated (79.5%), and from higher income (84.6%). At baseline, 19.2% (95% confidence interval [CI] 13.0%–25.4%) of women had high overall CVD risk awareness, while 63.5% (95% CI 55.9%–71.0%) had high female-specific CVD risk awareness. At 6-month follow-up, overall CVD risk awareness (19.2%–76.1%, p<0.001) and female-specific CVD risk awareness (63.5%–94.8%; p<0.001) significantly increased. Improvement in CVD risk awareness was not associated with higher physical activity (adjusted odds ratio 0.49; 95% CI 0.04–3.21; p=0.51) or heart-healthy diet (adjusted odds ratio 2.49; 95% CI 0.88–6.93; p=0.08) at 6-month follow-up. Conclusions: Attendance at a WHC significantly increased women's CVD risk awareness, however, this did not independently associate with lifestyle behaviours.