Page 177 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

3.5 Feasibility and effectiveness of a lifestyle intervention| 175
assessments290 or counselling for a healthy lifestyle and cardiovascular assessment at menopause291. Our study provides support to recommend the availability of postpartum lifestyle intervention in these guidelines.
Unanswered questions and future research
We suggest randomized controlled trials, to decrease selection bias, in varied populations with a follow-up period of several years to confirm efficacy and durability of postpartum lifestyle intervention after complicated pregnancies. Varied populations will help to increase generalisability of the results. A longer follow-up is needed to evaluate the durability of the effects on cardiometabolic risk factors. The ideal primary outcome of these studies would be cardiometabolic events, although the low prevalence of these events needs large cohorts. To further decrease selection bias, more research is needed on motivators and barriers of women to increase participation and adherence to lifestyle intervention.
Table 3.5.3. Response to process evaluation at 13 months postpartum, questionnaire A: General Questions (response 93/144=65%)
1 The intervention program was well adapted to women with a history of preeclampsia, foetal growth restriction of gestational diabetes mellitus
2 The intervention program was difficult to integrate into daily life
3 The increased risk of recurrence in a next pregnancy was an important motivator to participate in the study
4 The increased risk of future disease was an important motivator to participate in the study
5 An important motivator to participate with the
study was to improve my health
6 The course of my pregnancy was an important
motivator to participate in the study
Totally Agree
13% 56% 24%
2% 7% 25% 23% 35% 21%
23% 47% 11% 13% 47% 14% 25% 60% 4%
Absolutely Not Agree
8% -
47% 18% 16% 4%
15% 3% 22% 3% 11% 1%
Table 4.1. International guidelines on postpartum follow-up and lifestyle intervention after
preeclampsia