Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study
Hypertensive disorders in pregnancy (HDP) and cardiometabolic and kidney diseases are rising in low- and middle-income countries (LMICs). While HDP are risk factors for cardiometabolic and kidney diseases, cost-effective, scalable strategies for screening and prevention in women with a history of HD...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2023-04-01
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| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1195 |
| _version_ | 1827944814946025472 |
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| author | Salisu Mohammed Ishaku Kwame Adu-Bonsaffoh Natasha Housseine Roberta Lamptey Arie Franx Diederick Grobbee Charlotte E. Warren Joyce L. Browne |
| author_facet | Salisu Mohammed Ishaku Kwame Adu-Bonsaffoh Natasha Housseine Roberta Lamptey Arie Franx Diederick Grobbee Charlotte E. Warren Joyce L. Browne |
| author_sort | Salisu Mohammed Ishaku |
| collection | DOAJ |
| description | Hypertensive disorders in pregnancy (HDP) and cardiometabolic and kidney diseases are rising in low- and middle-income countries (LMICs). While HDP are risk factors for cardiometabolic and kidney diseases, cost-effective, scalable strategies for screening and prevention in women with a history of HDP are lacking. Existing guidelines and recommendations require adaptation to LMIC settings. This article aims to generate consensus-based recommendations for the prevention and screening of cardiometabolic and kidney diseases tailored for implementation in LMICs. We conducted a systematic review of guidelines and recommendations for prevention and screening strategies for cardiometabolic and chronic kidney diseases following HDP. We searched PubMed/Medline, Embase and Cochrane Library for relevant articles and guidelines published from 2010 to 2021 from both high-income countries (HICs) and LMICs. No other filters were applied. References of included articles were also assessed for eligibility. Findings were synthesized narratively. The summary of guiding recommendations was subjected to two rounds of Delphi consensus surveys with experts experienced in LMIC settings. Fifty-four articles and 9 guidelines were identified, of which 25 were included. Thirty-five clinical recommendations were synthesized from these and classified into six domains: identification of women with HDP (4 recommendations), timing of first counseling and provision of health education (2 recommendations), structure and care setting (12 recommendations), information and communication needs (5 recommendations), cardiometabolic biomarkers (8 recommendations) and biomarkers thresholds (4 recommendations). The Delphi panel reached consensus on 33 final recommendations. These recommendations for health workers in LMICs provide practical and scalable approaches for effective screening and prevention of cardiometabolic disease following HDP. Monitoring and evaluation of implementation of these recommendations provide opportunities for reducing the escalating burden of noncommunicable diseases in LMICs. |
| first_indexed | 2024-03-13T10:35:36Z |
| format | Article |
| id | doaj.art-fb3e40914bcd4c979c521b2a4b3ef44b |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-03-13T10:35:36Z |
| publishDate | 2023-04-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-fb3e40914bcd4c979c521b2a4b3ef44b2023-05-18T06:48:31ZengUbiquity PressGlobal Heart2211-81792023-04-01181212110.5334/gh.1195388Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi StudySalisu Mohammed Ishaku0https://orcid.org/0000-0001-7523-8812Kwame Adu-Bonsaffoh1https://orcid.org/0000-0002-3741-6646Natasha Housseine2https://orcid.org/0000-0002-1849-7815Roberta Lamptey3https://orcid.org/0000-0002-4260-9442Arie Franx4https://orcid.org/0000-0001-8801-5546Diederick Grobbee5https://orcid.org/0000-0003-4472-4468Charlotte E. Warren6https://orcid.org/0000-0002-1361-2618Joyce L. Browne7https://orcid.org/0000-0001-7048-3245Julius Global Health, Julius Center for Health Science and Primary Care, University Medical Center, UtrechtJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Obstetrics and Gynecology, University of Ghana Medical School, Korle Bu Teaching Hospital AccraJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Medical College, Aga Khan University, Dar es SalaamJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Family Health, Korle Bu Teaching Hospital and Department of Community HealthDepartment of Obstetrics and Gynecology, Erasmus Medical Center, RotterdamJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityPopulation Council, Washington, DCJulius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Obstetrics and Gynecology, University of Ghana Medical School, Korle Bu Teaching Hospital AccraHypertensive disorders in pregnancy (HDP) and cardiometabolic and kidney diseases are rising in low- and middle-income countries (LMICs). While HDP are risk factors for cardiometabolic and kidney diseases, cost-effective, scalable strategies for screening and prevention in women with a history of HDP are lacking. Existing guidelines and recommendations require adaptation to LMIC settings. This article aims to generate consensus-based recommendations for the prevention and screening of cardiometabolic and kidney diseases tailored for implementation in LMICs. We conducted a systematic review of guidelines and recommendations for prevention and screening strategies for cardiometabolic and chronic kidney diseases following HDP. We searched PubMed/Medline, Embase and Cochrane Library for relevant articles and guidelines published from 2010 to 2021 from both high-income countries (HICs) and LMICs. No other filters were applied. References of included articles were also assessed for eligibility. Findings were synthesized narratively. The summary of guiding recommendations was subjected to two rounds of Delphi consensus surveys with experts experienced in LMIC settings. Fifty-four articles and 9 guidelines were identified, of which 25 were included. Thirty-five clinical recommendations were synthesized from these and classified into six domains: identification of women with HDP (4 recommendations), timing of first counseling and provision of health education (2 recommendations), structure and care setting (12 recommendations), information and communication needs (5 recommendations), cardiometabolic biomarkers (8 recommendations) and biomarkers thresholds (4 recommendations). The Delphi panel reached consensus on 33 final recommendations. These recommendations for health workers in LMICs provide practical and scalable approaches for effective screening and prevention of cardiometabolic disease following HDP. Monitoring and evaluation of implementation of these recommendations provide opportunities for reducing the escalating burden of noncommunicable diseases in LMICs.https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1195hypertensive disorders in pregnancyrisks of future cardiometabolic diseasesprevention and screening strategies |
| spellingShingle | Salisu Mohammed Ishaku Kwame Adu-Bonsaffoh Natasha Housseine Roberta Lamptey Arie Franx Diederick Grobbee Charlotte E. Warren Joyce L. Browne Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study Global Heart hypertensive disorders in pregnancy risks of future cardiometabolic diseases prevention and screening strategies |
| title | Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study |
| title_full | Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study |
| title_fullStr | Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study |
| title_full_unstemmed | Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study |
| title_short | Prevention and Screening for Cardiometabolic Disease Following Hypertensive Disorders in Pregnancy in Low-Resource Settings: A Systematic Review and Delphi Study |
| title_sort | prevention and screening for cardiometabolic disease following hypertensive disorders in pregnancy in low resource settings a systematic review and delphi study |
| topic | hypertensive disorders in pregnancy risks of future cardiometabolic diseases prevention and screening strategies |
| url | https://account.globalheartjournal.com/index.php/up-j-gh/article/view/1195 |
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