International journal of women's health · 2026
Postpartum Cardiometabolic Screening and Recorded Nursing-Process Indicators After Gestational Diabetes and Hypertensive Disorders of Pregnancy: An Institutional Retrospective Cohort Study.
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Zhao Xiang, Wei Yan, Li Yanchun, Sun Tiantian, Fan Wenxin, Geng Susu, Wang Li
Аннотация
BACKGROUND: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) mark elevated postpartum cardiometabolic risk, but less is known about how recorded nursing-process indicators relate to screening completion within institutional postpartum follow-up pathways.
METHODS: This single-center retrospective cohort used an institutional postpartum follow-up analytic cohort from Zibo Central Hospital. Records of women delivered from January 1, 2021 to December 31, 2025 were reviewed through 84 days postpartum, and inclusion required sufficient follow-up, clinical covariate, nursing-process, and screening-completion information. The primary outcome was completion of an institutional cardiometabolic screening package comprising recorded postpartum blood pressure, postpartum BMI, glucose-related testing, and lipid profile. Modified Poisson regression estimated risk ratios (RRs) with sequential adjustment for delivery year, clinical covariates, and recorded nursing contact score.
RESULTS: Of 1286 candidate records, 800 women were included: 376 controls, 214 GDM only, 139 HDP only, and 71 coexisting GDM/HDP. Screening completion was 63.8%, 77.1%, 77.0%, and 88.7%, respectively. After delivery-year and clinical adjustment, GDM only (RR 1.18, 95% CI 1.05-1.33), HDP only (RR 1.18, 95% CI 1.03-1.35), and coexisting GDM/HDP (RR 1.37, 95% CI 1.20-1.57) had higher screening completion than controls. After adding nursing contact score, group associations attenuated; nursing contact score remained associated with screening completion (RR 1.11 per point, 95% CI 1.06-1.17). Among screened women, coexisting GDM/HDP showed the highest abnormal blood pressure, abnormal glucose, and BMI ≥30.0 kg/m2 rates.
CONCLUSION: Women with coexisting GDM/HDP had the highest documented screening completion and substantial observed cardiometabolic abnormality among screened records. Recorded nursing-process indicators were associated with screening completion within this selected institutional cohort, supporting pathway-level interpretation rather than causal intervention claims.
METHODS: This single-center retrospective cohort used an institutional postpartum follow-up analytic cohort from Zibo Central Hospital. Records of women delivered from January 1, 2021 to December 31, 2025 were reviewed through 84 days postpartum, and inclusion required sufficient follow-up, clinical covariate, nursing-process, and screening-completion information. The primary outcome was completion of an institutional cardiometabolic screening package comprising recorded postpartum blood pressure, postpartum BMI, glucose-related testing, and lipid profile. Modified Poisson regression estimated risk ratios (RRs) with sequential adjustment for delivery year, clinical covariates, and recorded nursing contact score.
RESULTS: Of 1286 candidate records, 800 women were included: 376 controls, 214 GDM only, 139 HDP only, and 71 coexisting GDM/HDP. Screening completion was 63.8%, 77.1%, 77.0%, and 88.7%, respectively. After delivery-year and clinical adjustment, GDM only (RR 1.18, 95% CI 1.05-1.33), HDP only (RR 1.18, 95% CI 1.03-1.35), and coexisting GDM/HDP (RR 1.37, 95% CI 1.20-1.57) had higher screening completion than controls. After adding nursing contact score, group associations attenuated; nursing contact score remained associated with screening completion (RR 1.11 per point, 95% CI 1.06-1.17). Among screened women, coexisting GDM/HDP showed the highest abnormal blood pressure, abnormal glucose, and BMI ≥30.0 kg/m2 rates.
CONCLUSION: Women with coexisting GDM/HDP had the highest documented screening completion and substantial observed cardiometabolic abnormality among screened records. Recorded nursing-process indicators were associated with screening completion within this selected institutional cohort, supporting pathway-level interpretation rather than causal intervention claims.