Page 199 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

postpartum lifestyle counseling (chapter 3.3) we found that all women expressed a need for participation in postpartum lifestyle counseling. They preferred participation to be tailored to individual preferences. A combination of face-to-face counseling supported by computer-tailored lifestyle advice appealed to them. With regard to motivators and barriers to the adoption of a healthy postpartum lifestyle (chapter 3.4) we found that although women expressed that they intended to live a healthy postpartum lifestyle, it was generally not achieved. Motivators included improving their own current health condition as well as modeling a healthy lifestyle for their children. Important barriers were reported to be lack of knowledge, poor post-pregnancy recovery and lack of professional support after delivery.
Chapter 3.5 describes the Pro-Active study: a specific pre-post controlled designed study to evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after complicated pregnancies to improve maternal risk factors for future cardiometabolic disease. Our results support feasibility and effectiveness of a lifestyle intervention after complicated pregnancies to improve maternal cardiometabolic risk factors. The proportion of eligible women who complied with the intervention was twice as high as in other primary lifestyle intervention studies, supporting the window of opportunity for lifestyle intervention after a complicated pregnancy. We also conclude that further randomized controlled studies are needed with longer follow-up to confirm our findings and evaluate durability. In the meantime, we suggest health care professionals to offer lifestyle interventions to women after complicated pregnancies.
Part 4 provides the general discussion on how the results of this thesis should make us rethink the interpretation of cardiometabolic complications of pregnancy. It presents preeclampsia as an independent risk factor of future
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