Primary care cardiovascular risk reduction after pregnancy complications: a qualitative systematic review.
Victoria Jane Hodges, Saminah Shareef, Carolyn A Chew-Graham et al.
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In 30 seconds
This qualitative systematic review examined women’s experiences of behavioural change to reduce cardiovascular risk after adverse pregnancy outcomes (APOs), drawing on studies from high-income countries with universal healthcare. Eighteen studies involving 339 women were included. The synthesis found that delayed physical and psychological recovery and competing family and work demands could impede change, while family-compatible approaches, awareness of cardiovascular risk, parenthood, and personalised professional advice could support it. Minority ethnic women were the majority in only two studies, and socioeconomic or ethnic data were missing from five, highlighting gaps in the evidence base.
Key findings
- The review included 18 studies involving 339 women; minority ethnic women formed the majority in only two studies.
- Delayed recovery and childcare, household, and work demands constrained women’s capability and opportunity to make behavioural changes.
- Family-integrated changes, awareness of cardiovascular risk, parenthood, and personalised healthcare advice supported motivation and engagement.
- The review identified tailored, proactive follow-up as supportive, particularly for minority ethnic and socioeconomically disadvantaged groups.
Why it matters
The findings frame post-APO cardiovascular prevention as a challenge shaped not only by individual motivation but also by recovery, family responsibilities, and access to relevant support. They suggest that services may need to make prevention feasible within family life and attend to unequal representation and needs, while recognising that the evidence synthesises experiences rather than testing intervention effectiveness.
What to keep in mind
The review was limited to high-income countries with universal healthcare. Minority ethnic women were the majority in only two studies, and socioeconomic or ethnic data were absent from five, limiting the evidence available on equity.