Preeclampsia, gestational diabetes and later risk of cardiovascular disease: Women's experiences and motivation for lifestyle changes explored in focus group interviews

Abstract

Background:Preeclampsia (PE) and gestational diabetes mellitus (GDM) are both associated with increasedrisk of future cardiovascular disease (CVD). Knowledge of the relationship between these pregnancycomplications and increased CVD risk enables early prevention through lifestyle changes. This study aimed toexplore women’s experiences with PE and/or GDM, and their motivation and need for information andsupport to achieve lifestyle changes.Methods:Systematic text condensation was used for thematic analysis of meaning and content of data from five focusgroup interviews with 17 women with PE and/or GDM, with a live birth between January 2015 and October 2017.Results:This study provides new knowledge of how women with GDM and/or PE experience pregnancy complicationsin a Nordic healthcare model. It reveals the support they wantand the important motivating factors for lifestyle change.We identified six themes: Trivialization of the diagnosis during pregnancy; Left to themselves to look after their ownhealth; The need to process the shock before making lifestyle changes (severe PE); A desire for information about futuredisease risk and partner involvement; Practical solutions in a busy life with a little one, and; Healthcare professionals canreinforce the turning point.The women with GDM wanted healthcare professionals to motivate them to continue the lifestyle changes introducedduring pregnancy. Those with severe PE felt a need for individualized care to ensure that they had processed theirtraumatic labor experiences before making lifestyle changes. Participants wantedtheir partner to be routinely involved toensure a joint understanding of the need for lifestyle changes.Motivation for lifestyle changes in pregnancy was linked toearly information and seeing concrete results.Conclusions:Women with PE and GDM have different experiences of diagnosis and treatment, which will affect thefollow-up interventions to reduce future CVD risk throughlifestyle change. For GDM patients, lifestyle changes inpregnancy should be reinforced and continued postpartum. Women with PE should be informed by their generalpractitioner after birth, and given a plan for lifestyle change. Those with severe PE will need help in processing thetrauma, and stress managementshould be routinely offered.