In a population-based cohort study that included more than one million patients, fewer than 1 in 5 women with hypertension disorders of pregnancy or gestational diabetes were screened for diabetes and dyslipidemia after their pregnancy.
Cardiovascular disease is the leading cause of death among women. Patients who develop hypertensive disorders of pregnancy or gestational diabetes are at increased risk for a future stroke or cardiovascular event. Screening for hypertension, cholesterol, and blood sugar is important for controlling heart disease risk factors.
The investigators examined data for 1,265,015 women aged younger than 50 years in Ontario, Canada, who were discharged after admission for live birth, stillbirth, or pregnancy termination between 2002 and 2019. They compared screening for diabetes and dyslipidemia in the first 3 years after delivery between women who developed pregnancy-related hypertension or diabetes (the exposed group) with those who did not (the unexposed group).
Exposed patients were older than unexposed patients (median age, 32 years vs 30 years), and 81.1% of exposed patients had pregnancy-related hypertension or diabetes during the index pregnancy. The remainder were exposed during a previous pregnancy.
Overall, 17.3% of women with gestational diabetes or hypertension were screened in the year following their pregnancy, and less than half (44%) were screened for dyslipidemia within 3 years of giving birth. Notably, most glycemic (87.8%) and lipid (93.7%) screening tests were ordered by family doctors.
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