Reducing diabetes and heart disease risk in women following pregnancy through risk stratification, primary care follow-up and community-based lifestyle management

We have a large scale National Heart Foundation MRFF Grant in Reducing cardio-metabolic risk of Australian women following pregnancy through risk stratification, primary care follow-up and community-based lifestyle management – Implementation research. Certain pregnancy related-conditions indicate an increased risk of heart disease later in life for women. These cardio-metabolic conditions include placental disorders, including hypertensive disorders (gestational hypertension or pre-eclampsia), fetal growth restriction, gestational diabetes and spontaneous preterm birth. Guidelines exist for some of these conditions to reduce the risk of heart disease following pregnancy including additional screening for risk factors for diabetes or heart disease and lifestyle management to optimise diet, physical activity and weight. However, these guidelines are poorly taken up by women and health professionals. There are also clinical gaps where we don’t know how to identify women with these conditions at the highest risk of later heart disease. Improving these gaps will thus reduce the risk of heart disease for these high-risk women later in life. We aim firstly to assess women during and post-pregnancy for a range of heart disease risk factors to identify the highest risk women for future heart disease. We will then co-design and adapt existing registry systems for screening and follow-up of women with gestational diabetes following birth to include these highest risk women. Finally, we will co-design and adapt the existing Diabetes Australia lifestyle management program (Life!) for prevention of future type 2 diabetes and cardiovascular disease for these highest risk women. This work is crucial to develop targeted screening, prevention and treatment opportunities during and following pregnancy to reduce maternal cardio-metabolic risk and future heart disease in high-risk women. There is an opportunity for a PhD student to be involved throughout this exciting research program. The student could be involved in a number of the different project components (as desired) across stakeholder engagement and implementation research, biostatistical analysis and risk prediction, intervention design and clinical trials. The student would join a thriving internationally leading multidisciplinary women’s health team working across clinical care and research.