title: Recognition by Women's Health Care Providers of Long-Term Cardiovascular Disease Risk After Preeclampsia.
abstract: OBJECTIVE
  To assess health care providers' knowledge regarding pregnancy outcome as a risk factor for cardiovascular disease and evaluate the variables associated with their responses to questions about routine surveillance for cardiovascular disease.
  
  
  METHODS
  A voluntary, anonymous survey of internal medicine and obstetric and gynecologic health care providers at an academic institution. Responses to a case-based and direct inquiry questionnaire were evaluated.
  
  
  RESULTS
  The overall response rate was 65% (173/265). When assessing cardiovascular risk, gynecologists compared with internists significantly more often requested a pregnancy history (44/49 [90%] compared with 56/75 [75%], P=.039) and more often attached importance to a history of preeclampsia (35/48 [73%] compared with 41/75 [55%], P=.028). When a history of preeclampsia was obtained, internists more often obtained a fasting glucose test (25/52 [48%] compared with 9/43 [20.9%], P=.009). A minority of health care providers recognized the importance of fetal growth restriction. Both health care provider groups demonstrated similar knowledge of general cardiovascular risk factors, screening tools, and interventions. Higher general cardiovascular knowledge was significantly associated with identification of pregnancy complications as cardiovascular risk factors (P=.001).
  
  
  CONCLUSIONS
  When assessing cardiovascular risk, internists were less likely than gynecologists to include a pregnancy history. However, once identified as at risk for cardiovascular disease, gynecologists were less likely than internists to obtain appropriate testing. Education concerning the link between certain pregnancy complications and future cardiovascular disease is needed. Areas of opportunity for education in both medical specialties are identified.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, the Division of General Medicine and Primary Care, Department of Medicine, and the Endocrinology, Diabetes and Hypertension Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Louise
authors.initials: L
authors.lastname: Wilkins-Haug
authors.forename: Ann
authors.initials: A
authors.lastname: Celi
authors.forename: Ann
authors.initials: A
authors.lastname: Thomas
authors.forename: Joseph
authors.initials: J
authors.lastname: Frolkis
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D016640:Diabetes, Gestational / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation; D006176:Gynecology / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008055:Lipids / Q000097:blood; D008487:Medical History Taking; D009774:Obstetrics / Q000706:statistics & numerical data; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D017584:Reproductive History; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids