Page 191 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

Discussion| 189 Figure 4.1. Possible effect of lifestyle intervention after complicated pregnancy on
cardiometabolic health and future disease (adapted from Sattar and Greer, 20021)
Population (1) with complicated pregnancy
Population (2) with healthy pregnancy
Threshold for cardiometabolic disease
Population identical to population (1) with postpartum lifestyle intervention
Neonatal life
Pregnancies Middle age
Age
coaches/counsellors. Follow-up should be at least 5 years, but preferably up to 10 years or longer and could be combined with a study on cardiometabolic screening strategies, e.g. yearly versus 5-yearly screening.
Primary outcome should ideally be the prevalence of cardiometabolic disease. However, intermediate cardiometabolic risk factors could be used, like weight, blood pressure, cholesterol and triglyceride-levels and exercise and fat intake.
Another interesting secondary outcome to study would be the risk of recurrent disease in a subsequent pregnancy. Preconceptionally initiated lifestyle intervention for weight reduction to reduce the risk of recurrent preeclampsia has not been studied yet296, but is suggested by a risk reduction if initiated during pregnancy284. Lifestyle intervention to increase physical activity has no effect on risk of preeclampsia if initiated during or before pregnancy297.
Cardiometabolic health