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‘Missed opportunity’: Most pregnant women do not undergo lipid screening
NEW ORLEANS — Lipid screening was underutilized in women during pregnancy, with a new study suggesting that up to three-quarters of women were not screened.
“This study highlights a population in which guideline-directed lipid screening is not being performed,” Dipika J. Gopal, MD, a fellow in the division of cardiology at the Hospital of the University of Pennsylvania, told Cardiology Today. “It is a missed opportunity to risk stratify these women in terms of their cardiovascular health, which can impact their future as well as their families.”
Researchers analyzed data from 5,101 women who gave birth and attended a postpartum visit within 180 days after delivery from March 2009 to August 2018. Data obtained included demographics and lipid values.
Before the postpartum date, 78% of women had not undergone lipid screening. Women who were screened were more likely to be white, older, and have hypertension, CAD and diabetes.
Among the 22% of women who were screened, 7% had an elevated total cholesterol greater than 240 mg/dL. In addition, 13% of these women had elevated triglycerides, defined as greater than 150 mg/dL.
“There are many reasons why screening may not be happening, which is what we plan to look into,” Gopal said in an interview. “This study should be a call to action for us to encourage lipid screening in his population.” – by Darlene Dobkowski
Reference:
Gopal DJ, et al. Session 1276 – Prevention: Clinical 4. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.
Disclosure: Gopal reports no relevant financial disclosures.
Perspective
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The peripartum period provides a critical window for assessment of a woman’s cardiovascular health and represents an opportunity to screen for hyperlipidemia. In addition, this should be incorporated with complications from pregnancy such as gestational diabetes and preeclampsia in assessing and treating CV risk.
Since women are engaged with the health care system during the peripartum period, this is an optimal time to assess CV risk and start early lifestyle and, if needed, pharmacologic intervention.
Further research is needed to assess what the difference in long-term outcomes in women who are screened vs. those who are not.