---
title: "Barriers and Facilitators to Postpartum CVD Prevention After Gestational Diabetes or Hypertensive"
id: "pubmed-40694664"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-40694664"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/40694664/"
doi: "10.1093/eurjpc/zwaf435"
published_at: "2026-09-22T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Barriers and Facilitators to Postpartum CVD Prevention After Gestational Diabetes or Hypertensive
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-40694664
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/40694664/)
- **DOI:** [10.1093/eurjpc/zwaf435](https://doi.org/10.1093%2Feurjpc%2Fzwaf435)
- **Published At:** 2026-09-22T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This scoping review synthesized evidence on barriers and facilitators to postpartum **cardiovascular disease (CVD)** screening and prevention for women with prior **gestational diabetes (GDM)** or **hypertensive disorders of pregnancy (HDP)**. - The authors searched Ovid Medline, CINAHL, and Embase and screened 18,565 records, ultimately including 29 studies (12 qualitative, 17 quantitative). - Individual-level barriers most commonly reported were knowledge gaps, health status and emotional factors; facilitators included personal motivation for better health and availability of postpartum programmes. - Interpersonal barriers included competing priorities, lack of family or friend support, and mistrust of healthcare providers; a key interpersonal facilitator was women's motivation to model healthy behaviours for their children. - Organizational barriers centered on gaps in communication; organizational facilitators included access to primary care, follow-up reminders, and programme availability in native languages. - System-level barriers most frequently reported involved gaps in insurance coverage; system facilitators were not emphasized in the abstract. - The review concludes that women with prior GDM or HDP face multi-level obstacles to accessing recommended postpartum CVD prevention services, from individual knowledge deficits to system-level healthcare disparities. - The abstract does not report detailed study-level characteristics, quantitative effect sizes, or methodological limitations; those details would require consultation of the full text.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/40694664/#linkout) Title & authors Abstract Conflict of interest statement Comment in Similar articles Publication types MeSH terms Related information Grants and funding LinkOut - more resources Eur J Prev Cardiol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Prev+Cardiol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Prev+Cardiol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/40694664/) . 2026 Sep 22;33(13):2324-2342. doi: 10.1093/eurjpc/zwaf435. # Barriers and facilitators of cardiovascular disease prevention services for women with prior gestational diabetes or hypertensive disorders of pregnancy: a scoping review [Dan Yedu Quansah](https://pubmed.ncbi.nlm.nih.gov/?term=Quansah+DY&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-2 "School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada."), [Sarah Visintini](https://pubmed.ncbi.nlm.nih.gov/?term=Visintini+S&cauthor_id=40694664)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-3 "Berkman Library, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Helena Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+H&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Faisal Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+F&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Laura Harris](https://pubmed.ncbi.nlm.nih.gov/?term=Harris+L&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Nichole Dai](https://pubmed.ncbi.nlm.nih.gov/?term=Dai+N&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Carley D O'Neill](https://pubmed.ncbi.nlm.nih.gov/?term=O%27Neill+CD&cauthor_id=40694664)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-4 "School of Kinesiology, Faculty of Professional Studies, Acadia University, Box 143, Wolfville, NS B4P 2R6, Canada."), [Karine Savard](https://pubmed.ncbi.nlm.nih.gov/?term=Savard+K&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Hassan Mir](https://pubmed.ncbi.nlm.nih.gov/?term=Mir+H&cauthor_id=40694664)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-5 "Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Thais Coutinho](https://pubmed.ncbi.nlm.nih.gov/?term=Coutinho+T&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-6 "Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA."), [Kerri-Anne Mullen](https://pubmed.ncbi.nlm.nih.gov/?term=Mullen+KA&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#full-view-affiliation-2 "School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada.") Affiliations Expand ### Affiliations * 1 Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 2 School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada. * 3 Berkman Library, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 4 School of Kinesiology, Faculty of Professional Studies, Acadia University, Box 143, Wolfville, NS B4P 2R6, Canada. * 5 Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 6 Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. * PMID: **40694664** * DOI: [ 10.1093/eurjpc/zwaf435 ](https://doi.org/10.1093/eurjpc/zwaf435) Free article Item in Clipboard # Barriers and facilitators of cardiovascular disease prevention services for women with prior gestational diabetes or hypertensive disorders of pregnancy: a scoping review Dan Yedu Quansah et al. Eur J Prev Cardiol. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Eur J Prev Cardiol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Eur+J+Prev+Cardiol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Eur+J+Prev+Cardiol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/40694664/) . 2026 Sep 22;33(13):2324-2342. doi: 10.1093/eurjpc/zwaf435. ### Authors [Dan Yedu Quansah](https://pubmed.ncbi.nlm.nih.gov/?term=Quansah+DY&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-2 "School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada."), [Sarah Visintini](https://pubmed.ncbi.nlm.nih.gov/?term=Visintini+S&cauthor_id=40694664)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-3 "Berkman Library, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Helena Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+H&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Faisal Ahmed](https://pubmed.ncbi.nlm.nih.gov/?term=Ahmed+F&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Laura Harris](https://pubmed.ncbi.nlm.nih.gov/?term=Harris+L&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Nichole Dai](https://pubmed.ncbi.nlm.nih.gov/?term=Dai+N&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Carley D O'Neill](https://pubmed.ncbi.nlm.nih.gov/?term=O%27Neill+CD&cauthor_id=40694664)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-4 "School of Kinesiology, Faculty of Professional Studies, Acadia University, Box 143, Wolfville, NS B4P 2R6, Canada."), [Karine Savard](https://pubmed.ncbi.nlm.nih.gov/?term=Savard+K&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Hassan Mir](https://pubmed.ncbi.nlm.nih.gov/?term=Mir+H&cauthor_id=40694664)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-5 "Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada."), [Thais Coutinho](https://pubmed.ncbi.nlm.nih.gov/?term=Coutinho+T&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-6 "Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA."), [Kerri-Anne Mullen](https://pubmed.ncbi.nlm.nih.gov/?term=Mullen+KA&cauthor_id=40694664)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-1 "Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40694664/#short-view-affiliation-2 "School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada.") ### Affiliations * 1 Canadian Women's Heart Health Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 2 School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada. * 3 Berkman Library, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 4 School of Kinesiology, Faculty of Professional Studies, Acadia University, Box 143, Wolfville, NS B4P 2R6, Canada. * 5 Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada. * 6 Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. * PMID: **40694664** * DOI: [ 10.1093/eurjpc/zwaf435 ](https://doi.org/10.1093/eurjpc/zwaf435) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** Although cardiovascular disease (CVD) screening and preventive care in the early postpartum are recommended for women with prior gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP), certain barriers limit access to such services. We conducted a scoping review to summarize evidence on the barriers and facilitators of CVD prevention services among women with prior GDM or HDP. **Methods and results:** A comprehensive search strategy was used to search articles published in three databases (Ovid Medline, CINAHL, Embase). Studies published in English or French that investigated and reported barriers or facilitators to postpartum CVD screening and preventive care among women with previous GDM and HDP were included. Out of 18 565 studies we screened, 29 studies (12 qualitative, 17 quantitative) were included. Main individual level barriers including lack of knowledge, health, and emotional factors were identified. Competing priorities, lack of family/friend support, and mistrust of healthcare providers were the most reported interpersonal level barriers, while gaps in communication were the most significant organizational barrier, and gaps in insurance coverage was the most reported system barrier. Individual level facilitators included a personal desire for better health and availability of postpartum programmes, and the most reported interpersonal facilitator was women's commitment to modelling a healthy lifestyle for their children. Organizational level facilitators were access to primary care providers and follow-up visit reminders, and programme availability in native languages. **Conclusion:** Women with prior GDM or HDP face significant barriers to accessing postpartum CVD prevention services. These barriers ranged from individual-level knowledge gaps to system-level healthcare disparities. **Keywords:** Barriers; CVD prevention; Facilitators; Gestational diabetes; Hypertensive disorders of pregnancy; Postpartum. © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Conflict of interest: none declared. ## Comment in * [ Post-partum: the window for implementing prevention into clinical practice. ](https://pubmed.ncbi.nlm.nih.gov/41566625/) Mihailidou AS. Mihailidou AS. Eur J Prev Cardiol. 2026 Sep 22;33(13):2343-2344. doi: 10.1093/eurjpc/zwag050. Eur J Prev Cardiol. 2026. PMID: 41566625 No abstract available. ## Similar articles * [ Barriers and facilitators to diabetes screening and prevention after a pregnancy complicated by gestational diabetes. ](https://pubmed.ncbi.nlm.nih.gov/36399472/) Sinha DD, Williams RC, Hollar LN, Lucas HR, Johnson-Javois B, Miller HB, Stoermer A, Colditz GA, James AS, Herrick CJ.Sinha DD, et al.PLoS One. 2022 Nov 18;17(11):e0277330. doi: 10.1371/journal.pone.0277330. eCollection 2022.PLoS One. 2022.PMID: 36399472Free PMC article. * [ A Qualitative Study on Barriers and Facilitators to Postpartum Cardiovascular Disease Risk Screening in Women with Hypertensive Disorders of Pregnancy: Perspectives from Patients and Healthcare Provider
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