Knowledge and Perception of Cardiovascular Disease Risk in Young Women of Reproductive Age

Abstract

Background: Cardiovascular disease (CVD) remains the leading cause of death in American women, but CVD knowledge and risk perception in women is declining. Little is known about how young women of reproductive age perceive their risk of CVD or if risk perception varies based on experience of adverse pregnancy outcomes (APO). The objective of this study was to determine whether women who have experienced an APO have a greater awareness of personal risk factors for CVD compared with women with uncomplicated pregnancies.Methods and Results: A self-administered online survey was distributed to 5,612 women who gave birth at an urban medical center between January 1 and July 1, 2020. Of 714 respondents, 182 (25%) reported experiencing an APO, which was defined as self-report of hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth, or a low birth weight infant. There was no significant difference in CVD knowledge scores between womenwho reported experiencing an APO and women with uncomplicated pregnancies (p= 0.51), and similar proportions of women in both groups (62%) identified CVD as the leading cause of death in women. Most women associated HDP (81%) and GDM (82%) with CVD risk, while few recognized preterm birth (13%) or low birth weight (11%) as CVD risk factors. Women who experienced an APO reported higher perception of risk for future CVD (adjusted odds ratio, 2.64[95% CI 1.83-3.80]) in comparison to women with uncomplicated pregnancies. However, half of women who experienced an APO reported average or below average risk for CVD, and only 41 (22.5%) reported speaking with a healthcare professional about CVD within the past year.Conclusions: The women in our sample were generally well educated about CVD risk factors, but significant gaps remain in the overall perception of personal CVD risk along with knowledge deficits related to a subset of pregnancy-related CVD risk factors and CVD mortality in women.

Acknowledgements

The authors also would like to acknowledge the AHA, Dr. Holly Gooding, and Dr. Elizabeth Walker for assistance with development of the survey instrument.

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