title: Cardiovascular risk reduction and weight management at a hospital-based postpartum preeclampsia clinic.
abstract: OBJECTIVE
  Women who develop preeclampsia during pregnancy are at high risk of developing future chronic diseases, including premature cardiovascular disease. We have established an interdisciplinary clinic that aims to prevent cardiovascular disease through educational counselling focused on lifestyle modifications in the early postpartum period. The objective of this study was to evaluate changes in weight and cardiovascular risk factors in participating women after six months of attendance at the clinic.
  
  
  METHODS
  We conducted a retrospective chart review of women who had a pregnancy complicated by preeclampsia, and who subsequently attended the Postpartum Preeclampsia Clinic. Study subjects had baseline assessments of lifestyle, physical, and laboratory parameters. Individualized goals for cardiovascular risk reduction and lifestyle were established, centering on physical activity and dietary modifications. The primary outcome was change in weight.
  
  
  RESULTS
  Over the study period, 21 women were seen for a minimum of six months of follow-up. At an average (± SD) of 4.4 ± 1.4 months postpartum, subjects showed a non-significant improvement in weight (mean weight loss of 0.4 ± 4.5 kg) and BMI (mean decrease in BMI 0.1 ± 1.7 kg/m2). Physical activity improved significantly, from 14% of subjects participating in physical activity before pregnancy to 76% at a mean of 4.4 months postpartum.
  
  
  CONCLUSIONS
  This study has demonstrated the early benefits of a longitudinal interdisciplinary intervention with counselling about lifestyle modifications for prevention of cardiovascular disease in women with recent preeclampsia. A study with a larger sample size and longer duration of follow-up is planned to confirm these findings.
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
authors.forename: Rahim
authors.initials: R
authors.lastname: Janmohamed
authors.affiliation: Nutrition Services, Alberta Health Services, Edmonton AB.
authors.forename: Erin
authors.initials: E
authors.lastname: Montgomery-Fajic
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB; Department of Medicine, University of Alberta, Edmonton AB.
authors.forename: Winnie
authors.initials: W
authors.lastname: Sia
authors.affiliation: Alberta Health Services, Edmonton AB.
authors.forename: Debbie
authors.initials: D
authors.lastname: Germaine
authors.affiliation: Alberta Health Services, Edmonton AB.
authors.forename: Jodi
authors.initials: J
authors.lastname: Wilkie
authors.affiliation: Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB; Department of Medicine, University of Alberta, Edmonton AB.
authors.forename: Rshmi
authors.initials: R
authors.lastname: Khurana
authors.affiliation: Ottawa Hospital Research Institute, University of Ottawa, Ottawa ON.
authors.forename: Kara A
authors.initials: KA
authors.lastname: Nerenberg
mesh_terms: D000328:Adult; D032763:Behavior Control / Q000379:methods*; D015992:Body Mass Index; D002170:Canada; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D037001:Directive Counseling / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior
keywords: health promotion and prevention; nutrition; postpartum care; preeclampsia; vascular disease; weight management