Page 188 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

186 | Part 4 Discussion
independent effect of preeclampsia. However, another study that support the conclusion that preeclampsia is an independent risk factor is the HUNT-trial. It is a longitudinal prospective follow-up program in Norway, measuring cardiometabolic risk factors in women every decade207. A cohort was defined that had given birth between the 1985 and 1995 check-up. Compared to women with a non-hypertensive pregnancy, women after hypertensive disorder in pregnancy (including preeclampsia) had a 0.8 kg/m2 increase in BMI, 6.2 mmHg increase in systolic blood pressure and 3.5 mmHg increase in diastolic blood pressure, adjusted for age at follow-up and pre-pregnancy values of BMI, systolic and diastolic blood pressure. While parity in general decreases risk of cardiovascular disease292, this confirms our finding that preeclampsia independently and irreversibly decreases cardiovascular health and thus increases the risk of future cardiovascular disease.
Lifestyle intervention after complicated pregnancy
Lifestyle intervention after complicated pregnancy is feasible and effective in improving cardiometabolic health. Participation rate in our study was twice as high as in other primary lifestyle interventions275 276. Compliance was fair with a drop-out rate of 29%60, but could be improved by offering lifestyle intervention closer to home or by phone.
Informing women of their risk profile made them more aware of their risk of future cardiometabolic disease. This was a good motivator to improve cardiometabolic health. However, women after a complicated pregnancy are having difficulties in finding time to invest in their own recovery. Caring duties for their, sometimes, prematurely or growth-restricted newborn take a lot of time. They perform worse on physical and psychological tests compared to women after an uncomplicated pregnancy149. Major determinants are NICU-