Postnatal primary care: Identifying opportunities for improving cardiovascular risk and mental health using the eLIXIR study data linkage

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Adopted project
1 June 2020 — adopted November 2019 • completed December 2020

Postnatal primary care: Identifying opportunities for improving cardiovascular risk and mental health using the eLIXIR study data linkage

Complications of pregnancy, such as pregnancy hypertension and gestational diabetes, are mainly managed by obstetrics and midwifery teams — but postnatal follow-up is largely the remit of primary care. Each of these conditions is associated with increased risk of hypertension, type 2 diabetes, and cardiovascular disease.

A window of opportunity

The postnatal period offers a critical window for improved cardiovascular health — yet there is a paucity of data on health outcomes following these physical complications of pregnancy.

This project aims to look at what primary care follow-up women in south London currently receive following hypertensive and diabetic pregnancies, and to identify where there may be opportunities for intervention and secondary prevention in primary care.

Project aims

The project addresses four key research questions:

Are women being monitored in primary care following hypertensive and diabetic pregnancies?

Are physical and mental health outcomes different in women who have had hypertensive and/or diabetic disorders of pregnancy?

Do monitoring and outcomes following hypertensive and diabetic pregnancies vary by socio-economic status and ethnicity?

Which factor in the postnatal period confers the greatest increase in cardiovascular risk in women who have had hypertensive and/or diabetic disorders of pregnancy?

How the research will be carried out

The research team will use three linked south London data sources:

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eLIXIR

early-LIfe data cross-LInkage in Research — health records and blood samples from mothers and children across a large south London population

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Lambeth DataNet

General practice records from women in maternity services, collected since October 2018

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CRIS

Mental health records from women in south London maternity services

All data are from a south London population, capturing the ethnic and socio-economic diversity of this urban area. Analyses will specifically examine whether there is inequality in care and outcomes by socio-economic status and ethnicity.

Patient and public involvement

A PPI group will focus on advice about dissemination of study findings, implications for provision of postnatal care, and potential interventions to improve long-term cardiovascular outcomes.

Benefits for people living in south London

The results will help to answer questions about:

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How women are being followed up in primary care following complex pregnancies

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How their physical and mental health outcomes differ from women with lower-risk pregnancies

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Whether outcomes and follow-up vary by socio-economic status and ethnicity

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What are the biggest contributing risk factors to women’s 10-year cardiovascular risk in the postnatal period — to inform targeted interventions

Funded by Professor Lucy Chappell’s NIHR Research Professorship and Dr Liza Bowen’s NIHR Academic Clinical Fellowship. Adopted by ARC South London November 2019. Completed December 2020.