Table 1.

Transitional Clinics for Women With HDP Published in Peer-Reviewed Literature

Transitional clinic	Population and timing	No. of participants	Methods	Reported outcomes	Conclusions	Limitations and challenges
MHC29 (Canada)	HDP, GD, preterm birth, IUGR, and placental abruption at approximately 6 mo post partum (control group: women with normal blood pressure from a separate study who did not participate in the MHC)	157	Provide risk assessment; communicate risk with PCP; make specialty referrals	30-y CVD risk was 7.5% (IQR, 5.9%-12.0%) in MHC participants and 5.3% (IQR, 4.0%-7.0%) in controls (P < .001); lifetime CVD risk was optimal in 16% of MHC patients and 54% of controls (P < .001)	MHC identifies women in early postpartum period at elevated CVD risk	Of patients who were referred to the MHC, 41% attended their appointment, including 86% of White women in the MHC group and 100% of White women in the control group
MCRRC30 (Canada)	High-risk MHC patients, approximately 5 mo from MHC referral to MCRRC appointment	48	High-risk MHC patients referred to cardiology for follow-up and consideration of cardiac rehabilitation	Median 30-y CVD risk score was 10.8% (IQR, 7.5%-17.0%) in MCRRC participants and 6.5% (IQR, 5.0%-10.0%) in nonreferred MHC participants (P < .001); lifetime CVD risk was optimal in 2% of MCRRC participants and 28% of nonreferred MHC participants (P < .001); 28 of 48 patients were eligible for cardiac rehabilitation referral, 19 of 28 eligible patients were referred, and 5 of 19 referred patients attended their appointment	Follow-up care with existing systems in place does not meet needs of high-risk postpartum women	Small sample size; predominantly White women
PPEC31 (Canada)	Preeclampsia at approximately 2 mo post partum; follow-up visits every 3-6 mo for 1 y	21	Educate patients about increased CVD risk; identify modifiable risk factors; work with an interdisciplinary team to address risk factors	Reported physical activity increased from 14% prepregnancy to 76% at 4.4 mo (P < .05); nonsignificant weight loss (−0.4 kg) and BMI reduction (−0.1)	Increased physical activity; nonsignificant improvements in weight and BMI	Small sample size; low referral rate to the PPEC; 75% of patients who were referred attended their first clinic visit; race and ethnicity were not reported
CMC32 (US)	HDP at approximately 16 d post partum with option to continue	412	Antihypertensive medication management; educate patients and clinicians about CVD risk and heart-healthy lifestyles; transition patients to PCP; provide referral to a nutritionist	Modification of antihypertensive medications in 48% of women; 87% of women attended a consultation with a nutritionist; 80% of women within the CMC health care system followed up with PCP	CMC aided in transfer of care; engagement with long-term clinicians (PCPs and nutritionists)	Of patients who were referred to the CMC, 25% did not attend their appointment; PCP follow-up data were unavailable for women outside of the CMC health care system

Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); CMC, Cardiometabolic Clinic; CVD, cardiovascular disease; GD, gestational diabetes; HDP, hypertensive disorders of pregnancy; IUGR, intrauterine growth restriction; MCRRC, Maternal Cardiovascular Risk Reduction Clinic; MHC, Maternal Health Clinic; PCP, primary care physician/clinician; PPEC, Postpartum Preeclampsia Clinic.