Date of Award

1-1-2020

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Melinda Irwin

Second Advisor

Jennifer Lewey

Abstract

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality with younger women being disproportionately affected by traditional risk factors including dyslipidemia. Despite recommendations for lipid screening in early adulthood, many younger women currently do not undergo screening. Prenatal and early pregnancy care represent underutilized opportunities for lipid screening and ASCVD risk assessment. We aimed to assess the prevalence and variations in pregnant women reporting a prior lipid screening and an awareness of high cholesterol as a risk factor for ASCVD.

METHODS: We administered a survey to 234 pregnant women receiving prenatal care at one of the three clinics affiliated with the University of Pennsylvania Health System to assess self-reported demographic and clinical variables, prior lipid screening characteristics, and risk factor awareness. Participants’ responses were augmented by screening data and previous lipid profile results from their electronic medical records (EMR).

RESULTS: A total of 200 pregnant women (86% response rate) completed the survey. Overall, 59% of pregnant women self-reported a previous lipid screening and 79% of women were aware of high cholesterol as an ASCVD risk factor. Stratified by racial/ethnic subgroups non-Hispanic (NH) Black women were less likely to report a prior screening (43% vs. 67%, p=0.022) and had lower levels of risk factor awareness (66% vs. 92%, p

CONCLUSIONS: Significant racial/ethnic and sociodemographic disparities persist in both the presence of a prior lipid screening and awareness of high cholesterol as an ASCVD risk factor. Prenatal and early pregnancy care are underutilized opportunities to enhance lipid screening among younger women and reduce variations in access to preventive care.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/27/2021

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