Pregnancy hypertension · 2025
Identifying cardiovascular health profiles in early pregnancy: A "Life's Essential 8"-based approach to assessing risk of hypertensive disorders of pregnancy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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DeBolt Chelsea A, Cohen Rebecca M, Zhao Zhan, McCarthy Katharine, Glazer Kimberly B
Аннотация
OBJECTIVES: This study aimed to characterize cardiovascular risk profiles in an obstetric population using American Heart Association's Life's Essential 8 components and investigate which combinations are associated with hypertensive disorders of pregnancy (HDP).
STUDY DESIGN: Secondary analysis of a prospective observational cohort, Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b).
MAIN OUTCOME MEASURES: We used latent class analysis to identify cardiovascular risk classes using Life's Essential 8 indicators at 6-14 weeks' gestation: blood pressure (BP), body mass index (BMI), and self-reported diet, sleep, smoke exposure, and physical activity. We assessed predictors of class membership and odds of HDP with logistic regression.
RESULTS: We identified a four-class solution with the following interpretative labels: (1) Healthy Behaviors/Normal BMI & BP (42%), (2) No Physical Activity/Normal BMI & BP (31%), (3) High Snoring/Elevated BMI (18%), and (4) Poor Behaviors/Normal BMI & BP (8%). Compared with the Healthy Behaviors/Normal BMI & BP class, individuals in the other risk profiles were more likely to be unmarried vs. married, Non-Hispanic Black vs. Non-Hispanic White, have government vs. commercial insurance, and report high vs. low periconceptual stress. Two risk profiles were associated with HDP: High Snoring/Elevated BMI had 2.4 times (95% CI 2.1-2.8) the odds and Poor Behaviors/Normal BMI & BP had 1.5 times (95% CI 1.2-1.8) the odds of HDP compared with Healthy Behaviors/Normal BMI & BP.
CONCLUSIONS: Two cardiovascular risk profiles-High Snoring/Elevated BMI and Poor Behaviors/Normal BMI & BP-were linked to HDP, emphasizing the potential for personalized, multifactorial interventions targeting modifiable behaviors to reduce risk.
STUDY DESIGN: Secondary analysis of a prospective observational cohort, Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b).
MAIN OUTCOME MEASURES: We used latent class analysis to identify cardiovascular risk classes using Life's Essential 8 indicators at 6-14 weeks' gestation: blood pressure (BP), body mass index (BMI), and self-reported diet, sleep, smoke exposure, and physical activity. We assessed predictors of class membership and odds of HDP with logistic regression.
RESULTS: We identified a four-class solution with the following interpretative labels: (1) Healthy Behaviors/Normal BMI & BP (42%), (2) No Physical Activity/Normal BMI & BP (31%), (3) High Snoring/Elevated BMI (18%), and (4) Poor Behaviors/Normal BMI & BP (8%). Compared with the Healthy Behaviors/Normal BMI & BP class, individuals in the other risk profiles were more likely to be unmarried vs. married, Non-Hispanic Black vs. Non-Hispanic White, have government vs. commercial insurance, and report high vs. low periconceptual stress. Two risk profiles were associated with HDP: High Snoring/Elevated BMI had 2.4 times (95% CI 2.1-2.8) the odds and Poor Behaviors/Normal BMI & BP had 1.5 times (95% CI 1.2-1.8) the odds of HDP compared with Healthy Behaviors/Normal BMI & BP.
CONCLUSIONS: Two cardiovascular risk profiles-High Snoring/Elevated BMI and Poor Behaviors/Normal BMI & BP-were linked to HDP, emphasizing the potential for personalized, multifactorial interventions targeting modifiable behaviors to reduce risk.