Improving screening and management of women with cardiometabolic conditions during pregnancy

Associate Professor Lisa Moran, Institution: Monash University

2020 Vanguard Grant

Years funded: 2021-2022

During pregnancy, women can develop certain conditions which can indicate that they have a higher risk of heart disease later in life. These include gestational diabetes, gestational hypertension or pre-eclampsia or gaining too much weight during pregnancy. Combined, these conditions can affect a third to up to a half of all pregnant women. The recommended treatment for all of these conditions is lifestyle management including aiming for optimal diet and physical activity patterns. The earlier women receive this treatment then the lower the risk of these conditions will be and the lower their risk of both a complicated pregnancy and heart disease following pregnancy.

To reduce the risk of heart disease further, women with these complications should receive additional screening for diabetes, high blood pressure or heart disease and lifestyle treatment following birth. However, currently there are gaps in clinical care where we don’t know how to identify women at higher risk of these conditions during pregnancy, we don’t start lifestyle treatment early enough and we don’t offer women additional support following pregnancy. Improving all of these clinical gaps will therefore reduce the risk of heart disease for many women.

We aim to firstly to develop a tool for identifying which women are at the highest risk of developing these conditions during pregnancy. We will then modify our previous successful lifestyle interventions for women during pregnancy to be relevant for all women identified by this tool and to be compatible with a digital (web and mobile phone based) format. We will also extend the intervention to also include appropriate screening and lifestyle management for women following childbirth. We will then develop detailed protocols for how to test and evaluate this project (risk prediction tool and digital health intervention during and post-pregnancy) in a public hospital setting for future studies.