Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Obstetric Quality and Safety

Poster Session 3

(874) Utilizing a cascade approach to identify gaps in care transitions for hypertensive disorders of pregnancy

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
Hypertensive disorders of pregnancy (HDP) affect one in 10 pregnancies in the United States, increasing long-term cardiovascular disease (CVD) risk. However, the minority of individuals with HDP attend a primary care provider visit (PCV) in the first year postpartum. Cascade analysis has been used in other populations to identify gaps in care transitions.

Study Design:
A stakeholder-engaged process defined key operational steps in primary care transition, including correct identification of primary care provider (PCP), PCV scheduling and attendance, and CVD counseling at PCV. A cascade analysis identified steps with significant attrition among a retrospective cohort of individuals with HDP who delivered at a single academic center from January to June 2023. Multinomial logistic regression identified predictors of completion of each step.

Results:
389 patients were included. Steps with highest levels of attrition were PCV scheduling (-14.1%, Figure 1) and CVD counseling at PCV (-36.0%). In adjusted analysis, public insurance, non-English language preference (NELP), gestational age at prenatal care initiation and NICU admission predicted attrition (Table 1). Publicly insured individuals were less likely to attend PCV (aOR 0.40, 95% CI 0.22-0.73). Individuals with NELP were more likely to have a correctly identified PCP (aOR 5.66, 95% CI 1.22-26.22) and CVD counseling at PCV (aOR 11.12, 95% CI 1.64-75.25). Individuals who initiated prenatal care later were less likely to have a correctly identified PCP (aOR 0.91, 95% CI 0.85-0.98) and attend PCV (aOR 0.94, 95% CI 0.90-0.99). Individuals with children admitted to NICU were more likely to schedule PCV (aOR 16.13, 95% CI 2.58-100.84).

Conclusion:
Utilizing a cascade approach to primary care transitions for individuals with HDP identifies operational steps which can be targeted by tailored quality improvement interventions. The most impactful opportunities to mitigate long-term CVD risk include correct identification of PCP and effective handoffs between OB providers and PCPs communicating this risk profile.