Page 172 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

170 | Part 3 Lifestyle intervention DISCUSSION
We found a high proportion of eligible women who complied with the intervention, and women had a significant weight loss after the intervention, supporting feasibility and effectiveness of lifestyle intervention to improve maternal cardiometabolic risk factors.
Feasibility
The proportion of eligible women who complied with the intervention was 23%, twice the percentage we assumed (11%). Participation rate in the intervention group was 35%, which was higher than the expected 15%. On the other hand, adherence in the intervention group was 65%, which was lower than the expected 75%.
Participation rate in our study was twice as high as in other primary lifestyle interventions275 276. We showed that the pregnancy complication, the perceived increased risk of future disease and the risk of recurrence in a next pregnancy were strong motivators to comply with the study. This supports the idea that a complicated pregnancy opens a window of opportunity for lifestyle intervention. Adherence to the intervention (65%) was lower than expected. The main reason for drop-out was lack of time and was 4 times higher in the first half of the follow-up compared to the second half. Prior research showed that women generally prefer the location of the counselling close to home186, suggesting that offering the lifestyle intervention in a primary health care setting might increase participation and adherence.
Only two recent studies on lifestyle interventions after metabolic complicated pregnancy reported participation and adherence rates. Both studies aimed to reduce the risk of type 2 diabetes mellitus in women with a history of