Abstract Body: Introduction: Poor pre-pregnancy cardiovascular health is associated with adverse pregnancy outcomes (APOs). We sought to investigate whether estimated 30-year CVD risk from the PREVENT equation similarly predicts APOs.
Hypothesis: We hypothesized that higher 30-year CVD risk mid-pregnancy would be associated with greater risk of APOs, including preterm delivery and preeclampsia.
Methods: Participants are from the Stress, Pregnancy, and Health (SPAH) study, conducted in Evanston, IL between 2018-2023. During the 2^nd trimester study visit, blood pressure was measured and participants provided a blood sample. Nuclear magnetic resonance was used to measure serum cholesterol and creatinine (used to estimate eGFR). Medication use, pre-gestational diabetes diagnosis, and APOs, including preterm delivery (<37 weeks gestation), early preterm delivery (<34 weeks) and preeclampsia, were abstracted from medical records. The PREVENT equation was used to estimate 30-year CVD risk based on 2^nd trimester measures. Logistic models were used to test associations between CVD risk in pregnancy and APOs, adjusted for race/ethnicity, as a marker of structural factors, socioeconomic position, based on household educational attainment and occupational prestige, and gestational age at the study visit.
Results: SPAH included 605 participants, 524 of whom had complete data to estimate 30-year CVD risk from the 2^nd trimester study visit (mean gestational age at visit: 23.7 weeks, SD: 1.7). The mean age of participants was 33.3 years (SD: 5.5) and 18% identified as Black, 21% as Hispanic, 49% as White, and 12% as another group. The mean 30-year CVD risk during pregnancy was 7.6% (SD: 6.6), 11% delivered preterm, and 10% developed preeclampsia. In the adjusted model, a 1 SD increase in CVD risk was associated with 41% greater odds of preterm delivery (95% CI: 1.14, 1.74), 67% greater odds of early preterm delivery (95% CI: 1.27, 2.19), and 71% greater odds of developing preeclampsia (95% CI: 1.36, 2.14; Figure 1).
Conclusions: Results suggest that a higher PREVENT 30-year estimated CVD risk in mid-pregnancy is associated with greater odds of delivering preterm and developing preeclampsia. These APOs are associated with long-term offspring CVD risk, also highlighting the intergenerational implications of PREVENT CVD risk estimates.