Author:
Rossiter Chris,Henry Amanda,Roberts Lynne,Brown Mark A.,Gow Megan,Arnott Clare,Salisbury Justine,Ruhotas Annette,Hehir Angela,Denney-Wilson Elizabeth
Abstract
Abstract
Background
Hypertensive disorders of pregnancy have longer-term implications, increasing women’s lifetime cardiovascular disease risk. The Blood Pressure Postpartum study is a multi-centre randomised three-arm trial of interventions, ranging in intensity and including education and lifestyle coaching, to support women to maintain or adopt healthy eating and physical activity during the first postpartum year. This qualitative sub-study nested within the main trial aimed to investigate whether and how women adopted healthy behaviours after a pregnancy complicated by a hypertensive disorder.
Methods
Semi-structured telephone interviews were recorded, transcribed and analysed thematically, following Braun and Clarke principles. They explored behaviour change among new mothers following their hypertensive pregnancy, and the intervention’s effect on their capacity and motivation to pursue healthy lifestyles.
Results
Thirty-four women from all three trial arms participated at 10–12 months postpartum. The three main themes were 1) Awareness of cardiovascular risk: some did not acknowledge the health risks, whereas others embraced this information. 2) Sources of motivation: while the majority were motivated to make a concerted effort to adapt their health behaviour, motivation often centred on their baby and family rather than their own needs. 3) Sustaining behaviour change with a new baby: women in the more intensive intervention arm demonstrated increased recognition of the importance of reducing cardiovascular health risks, with greater motivation and guidance to change their health behaviour. There was minimal evidence of crossover amongst groups, with women largely accepting their randomised level of intervention and not seeking additional help when randomised to minimal intervention.
Conclusions
Among women participating in an early post-hypertensive disorders of pregnancy randomised controlled trial aimed at improving their cardiovascular disease risk profile, the majority recognised the future health risks and appeared motivated to improve their lifestyle, particularly women in the highest-intensity intervention group. This highlights the importance of structured support to assist women embrace healthy lifestyles especially during the challenges of new parenthood.
Trial registration
The Blood Pressure Postpartum study was prospectively registered as a clinical trial with the Australian New Zealand Clinical Trials Registry (anzctr.org.au) on 13 December 2018 (registration number: ACTRN12618002004246).
Funder
NSW Health Translational Research Grants Scheme
National Health and Medical Research Council (Australia) Early Career Fellowship
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference35 articles.
1. Payne B, Hanson C, Sharma S, Magee L, von Dadelszen P. Epidemiology of the hypertensive disorders of pregnancy. The FIGO Textbook of Pregnancy Hypertension. 2016. p. 63–74.
2. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Audibert F, et al. Diagnosis, evaluation, and management of hypertensive disorders of pregnancy: Executive summary. J Obstet Gynaecol Can. 2014;36(5):439–41.
3. McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ. Cardiovascular sequelae of preeclampsia/eclampsia: A systematic review and meta-analyses. Am Heart J. 2008;156(5):918–30.
4. Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with pre-eclampsia: Systematic review and meta-analysis. Eur J Epidemiol. 2013;28(1):1–19.
5. Theilen LH, Fraser A, Hollingshaus MS, Schliep KC, Varner MW, Smith KR, et al. All-Cause and Cause-Specific Mortality after Hypertensive Disease of Pregnancy. Obstet Gynecol. 2016;128(2):238–44.
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献