Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth
Abstract Preeclampsia is associated with a substantially increased long-term risk for cardiovascular, cerebrovascular and renal disease. It remains unclear whether and to which extent specialized medical postpartum care is sought. We aimed to assess current utilization of postpartum primary and spec...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-25596-2 |
| _version_ | 1811188233254469632 |
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| author | Anna S. Scholz Kathrin Hassdenteufel Raphael Gutsfeld Mitho Müller Maren Goetz Armin Bauer Markus Wallwiener Sara Y. Brucker Stefanie Joos Miriam Giovanna Colombo Sabine Hawighorst‑Knapstein Ariane Chaudhuri Frauke Beck Stephanie Wallwiener |
| author_facet | Anna S. Scholz Kathrin Hassdenteufel Raphael Gutsfeld Mitho Müller Maren Goetz Armin Bauer Markus Wallwiener Sara Y. Brucker Stefanie Joos Miriam Giovanna Colombo Sabine Hawighorst‑Knapstein Ariane Chaudhuri Frauke Beck Stephanie Wallwiener |
| author_sort | Anna S. Scholz |
| collection | DOAJ |
| description | Abstract Preeclampsia is associated with a substantially increased long-term risk for cardiovascular, cerebrovascular and renal disease. It remains unclear whether and to which extent specialized medical postpartum care is sought. We aimed to assess current utilization of postpartum primary and specialized care and medication prescription behavior in women who experienced preeclampsia. This retrospective observational study based on statutory claims data included 193,205 women with 258,344 singleton live births between 2010 and 2017 in Southern Germany. Postpartum care was evaluated by analyzing and comparing the frequency of medical consultations in primary and specialized care and prescriptions for antihypertensive medication among women with and without preeclampsia up to 7.5 years after delivery. Gynecologists and general practitioners were the main health care providers for all women. Although specialized postpartum care was sought by more women after preeclampsia, the effect size indices revealed no considerable association between a history of preeclampsia and the utilization of specialized outpatient aftercare (e.g. 2% vs. 0.6% of patients with and without preeclampsia who consulted a nephrologist during the first year postpartum, r = 0.042). Preeclampsia was associated with an increased risk to take any antihypertensive medication after delivery (HR 2.7 [2.6; 2.8]). Postpartum referral to specialized outpatient care and quarterly prescriptions of antihypertensives following preeclampsia failed to match the early and rapidly increased incidence and risk of hypertension. These data highlight the missed opportunity to implement a reasonable follow-up strategy and prevention management in order to achieve long-term clinical benefits. |
| first_indexed | 2024-04-11T14:16:49Z |
| format | Article |
| id | doaj.art-c17b5a53eef44863be9dc49f22aa5bc7 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T14:16:49Z |
| publishDate | 2022-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-c17b5a53eef44863be9dc49f22aa5bc72022-12-22T04:19:24ZengNature PortfolioScientific Reports2045-23222022-12-0112111110.1038/s41598-022-25596-2Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birthAnna S. Scholz0Kathrin Hassdenteufel1Raphael Gutsfeld2Mitho Müller3Maren Goetz4Armin Bauer5Markus Wallwiener6Sara Y. Brucker7Stefanie Joos8Miriam Giovanna Colombo9Sabine Hawighorst‑Knapstein10Ariane Chaudhuri11Frauke Beck12Stephanie Wallwiener13Department of Gynecology and Obstetrics, Heidelberg University HospitalDepartment of Gynecology and Obstetrics, Heidelberg University HospitalDepartment of Psychology, Ludwig Maximilian UniversityDepartment of Psychology, Ludwig Maximilian UniversityDepartment of General Pediatrics, University Children’s HospitalDepartment of Women’s Health, University Hospital TuebingenDepartment of Gynecology and Obstetrics, Heidelberg University HospitalDepartment of Women’s Health, University Hospital TuebingenInstitute for General Practice and Interprofessional Care, University Hospital TuebingenInstitute for General Practice and Interprofessional Care, University Hospital TuebingenDepartment of Health Promotion, AOK Baden-WuerttembergDepartment of Health Promotion, AOK Baden-WuerttembergDepartment of Health Promotion, AOK Baden-WuerttembergDepartment of Gynecology and Obstetrics, Heidelberg University HospitalAbstract Preeclampsia is associated with a substantially increased long-term risk for cardiovascular, cerebrovascular and renal disease. It remains unclear whether and to which extent specialized medical postpartum care is sought. We aimed to assess current utilization of postpartum primary and specialized care and medication prescription behavior in women who experienced preeclampsia. This retrospective observational study based on statutory claims data included 193,205 women with 258,344 singleton live births between 2010 and 2017 in Southern Germany. Postpartum care was evaluated by analyzing and comparing the frequency of medical consultations in primary and specialized care and prescriptions for antihypertensive medication among women with and without preeclampsia up to 7.5 years after delivery. Gynecologists and general practitioners were the main health care providers for all women. Although specialized postpartum care was sought by more women after preeclampsia, the effect size indices revealed no considerable association between a history of preeclampsia and the utilization of specialized outpatient aftercare (e.g. 2% vs. 0.6% of patients with and without preeclampsia who consulted a nephrologist during the first year postpartum, r = 0.042). Preeclampsia was associated with an increased risk to take any antihypertensive medication after delivery (HR 2.7 [2.6; 2.8]). Postpartum referral to specialized outpatient care and quarterly prescriptions of antihypertensives following preeclampsia failed to match the early and rapidly increased incidence and risk of hypertension. These data highlight the missed opportunity to implement a reasonable follow-up strategy and prevention management in order to achieve long-term clinical benefits.https://doi.org/10.1038/s41598-022-25596-2 |
| spellingShingle | Anna S. Scholz Kathrin Hassdenteufel Raphael Gutsfeld Mitho Müller Maren Goetz Armin Bauer Markus Wallwiener Sara Y. Brucker Stefanie Joos Miriam Giovanna Colombo Sabine Hawighorst‑Knapstein Ariane Chaudhuri Frauke Beck Stephanie Wallwiener Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth Scientific Reports |
| title | Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth |
| title_full | Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth |
| title_fullStr | Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth |
| title_full_unstemmed | Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth |
| title_short | Observational database study on preeclampsia and postpartum medical care up to 7.5 years after birth |
| title_sort | observational database study on preeclampsia and postpartum medical care up to 7 5 years after birth |
| url | https://doi.org/10.1038/s41598-022-25596-2 |
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