Interconception preventive care and pregnancy complications

Pregnancy complications can recur, and interconception preventive care may help reduce some pregnancy complications. Preventive visits after an index pregnancy were associated with reduced hypertension in the subsequent pregnancy, according to a study published in the Journal of Women’s Health.

Pregnancy complications such as gestational diabetes, pregnancy-induced hypertension, and prematurity may recur across pregnancies and are increasingly recognized as risk factors for long-term cardiovascular disease in women. The goal of the study by Emily Gregory, MD, from the Children’s Hospital of Philadelphia, and co-authors, was to assess whether preventive care during the year following a birth was associated with a reduction in complication recurrence among a population of Medicaid patients.

Nearly half of the women included in the study experienced a complication in their subsequent pregnancy. Women with diabetes had the highest rate of recurrence (48.3%), followed by hypertension (38.0%) and preterm birth (28.1%). There was a decreased odds of any pregnancy complication in the subsequent birth for women who had preventive visits. This was driven by a decrease in odds of hypertension recurrence. There was no association between preventive care and the outcomes of diabetes or preterm birth.

“Women who experience pregnancy complications should have access to high-quality interconception health care, but may also require additional support to ensure optimal health in subsequent pregnancies and throughout the life course,” conclude the investigators.

“These authors found that 47.7% of Medicaid-insured women who experienced prematurity, hypertension, or diabetes during an index pregnancy experienced one of these complications during their subsequent pregnancy. Interconception preventive care is a helpful strategy in reducing the risk of recurrence of hypertension as a complication of the subsequent pregnancy,” says Journal of Women’s Health Editor-in-Chief Susan G. Kornstein, MD, Executive Director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, VA.