SOMANZ Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Embedding the 4HER post-pregnancy cardiometabolic health clinic – defining women’s needs. (#158)

Shelley Wilkinson 1 2 3 , Vishwas Raghunath 1 4 , Julian Pavey 1 5 , David McIntyre 1 6 7 , Josephine Laurie 1 6
  1. Obstetric Medicine, Mater Mothers' Hospital, Brisbane, Queensland, Australia
  2. Principal Dietitian, Lifestyle Maternity, Brisbane, Queensland , Australia
  3. Implementation Fellow, School of Pharmacy & Pharmaceutical Sciences, The University of Queensland, Brisbane, Queensland, Australia
  4. Nephrology, Ipswich Hospital, Queensland Health, Ipswich, Queensland, Australia
  5. The University of Queensland, Brisbane, QLD, Australia
  6. Mater Research Institute-The University of Queensland, Brisbane
  7. Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia

Background The Canadian MotHERS program demonstrated the effectiveness of a paradigm shift to position pregnancy as a predictor of future health. Our aim was to adapt and evaluate this program at the Mater Mothers’ Hospitals in Brisbane, Australia. We developed a clinic, available to women at three months post-delivery, focussed on risk reduction with systematic connection to primary care.

Methods Applying an action-research approach we embedded the 4HER (health, education, research, and screening) clinic into public and private services from November 2024. Existing patients with gestational diabetes or hypertensive disorders of pregnancy were invited to the service at d2-4 postpartum for +3 month and +9 month visits. Resources were sent to women and their GPs at set times to educate and gather data in preparation for and following visits, with women encouraged to see their GPs ~6 months postpartum. Our 4HER clinic evaluation primary outcome is change in cardiovascular risk score over time. Secondary outcomes will also be measured. We will evaluate the implementation using the RE-AIM Model.

Results From November 2024 to June 2025, 122 women attended 4HER (64% public). Women were aged 34.6 (±4.7) years, with a BMI of 29.4±6.6 kg/m2 and waist circumference 123.4±144.0 cm. Their baseline cardiovascular risk score was 31.8%(±11.9). 

Conclusions Baseline characteristics of 4HER attendees demonstrate an elevated risk of heart disease in their lifetime. Reviewing women’s clinic and GP engagement, and health habit changes as well as subsequent impact on their health measures, will provide direction to ongoing clinic development and delivery.