Postpartum Cardiometabolic Screening and Recorded Nursing-Process Indicators After Gestational Diabetes and Hypertensive Disorders of Pregnancy: An Institutional Retrospective Cohort Study.

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.