Inadequate postpartum screening for hypertension and diabetes a ‘missed opportunity’ for women, study suggests

February 17, 2025 – Less than one in five patients are tested for cardiovascular risk factors following pregnancy-related hypertension or diabetes, according to a new study published in the "Go Red for Women" issue of Circulation.  

Cardiovascular diseases are a leading cause of death among women. People who develop hypertensive disorders of pregnancy or gestational diabetes are at a higher risk of experiencing a future stroke or heart disease. Screening for high blood pressure, lipids, and sugars plays a crucial role in the early diagnosis of risk factors for cardiovascular disease.  

"There's increasing evidence that maternal health during pregnancy is associated with long-term vascular health,” says Dr. Amy Yu, neurologist and senior scientist at Sunnybrook Research Institute, and adjunct scientist with ICES.  

“Guidelines recommend that women with high blood pressure or sugar during pregnancy should have their blood sugar and cholesterol checked after the pregnancy, so we set out to evaluate whether Ontarians were getting these tests done.” 

Researchers from ICES and Sunnybrook Health Sciences Centre studied over a million pregnant individuals in Ontario, Canada, between 2002 and 2019. They compared screening for diabetes and dyslipidemia in the first three years after delivery between those who developed pregnancy-related hypertension or diabetes (exposed group) and those who did not (unexposed group). 

Key Findings 

• Fewer than 1 in 5 individuals (17%) diagnosed with gestational diabetes or hypertension were screened in the year following pregnancy. 

• Less than half (44%) of individuals received these tests within three years. Rates for screening for high cholesterol were lower than screening for diabetes. 

• Surprisingly, 33% of pregnant individuals without gestational diabetes or hypertension received these screening tests. 

Given that the gap in screening was more prominent for lipids than diabetes, the authors suggest that access to physicians for cardiovascular preventive care may not be the main cause of these lower screening rates. There may instead be a need for increased awareness of pregnancy-related cardiovascular disease risks among physicians and patients. 

"Women should be aware of their risk for cardiovascular disease, so that they can ask their doctors about risk factor screening,” says Dr. Yu, who is also an Associate Professor in Temerty Faculty of Medicine's Department of Medicine at the University of Toronto. “Having this knowledge can also support patients’ decision-making about lifestyle changes, which could improve their vascular health.” 

ICES is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on BlueSky: @ICESOntario 

Sunnybrook Health Sciences Centre is inventing the future of health care for the 1.3 million patients the hospital cares for each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier academic health sciences centres. Sunnybrook specializes in caring for high-risk pregnancies, critically-ill newborns and adults, offering specialized rehabilitation and treating and preventing cancer, cardiovascular disease, neurological and psychiatric disorders, orthopaedic and arthritic conditions and traumatic injuries. The Hospital also has a unique and national leading program for the care of Canada’s war veterans. www.sunnybrook.ca  

FOR FURTHER INFORMATION PLEASE CONTACT: 

Misty Pratt 
Senior Communications Associate, ICES 
Media@ices.on.ca  
343-961-6982