Page 190 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

188 | Part 4 Discussion
Scientific implications
The way this thesis changes our view on cardiometabolic complications of pregnancy is summarized in figure 4.1. The finding that cardiovascular recovery after preeclampsia could take as long as 2 years after delivery is presented in a less steep slope of the curve toward cardiometabolic recovery after a cardiometabolic complicated pregnancy. The finding that cardiometabolic complicated pregnancy is an independent risk factor of future disease is displayed by cardiometabolic health not returning to the ‘base curve’ after complicated pregnancy. Finally, the finding that lifestyle intervention is a feasible and might be an effective way to offer a chance of a healthier future is presented in the dotted line after cardiometabolic complicated pregnancy.
More knowledge is needed on the costs and benefits of postpartum screening strategies for cardiovascular traits.
Our study was not designed to prove the effect of lifestyle intervention, nor to do a cost-benefit analysis. Our findings on the effect of lifestyle intervention after cardiometabolic complicated pregnancy need to be confirmed in randomized controlled trials, comparing different intervention strategies. Inclusion criteria can be the same as in our Pro-Active study. More ethnicities should be included, offering them written material, questionnaires and counselling session in their native language. Lifestyle intervention could be initiated as early as 6 weeks postpartum, but start of the program must be tailored to the individual needs of the woman. Lifestyle intervention should be organized close to home by involving gynecologists and midwifes (responsible for the identification of women) primary health care physicians (responsible for organizing the initiation of lifestyle intervention) and trained