Associations of Ideal Cardiovascular Health and Lipid Fractions in Pregnancy with Obstetric and Neonatal Outcomes: Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study

Cardiovascular disease (CVD) is a major health burden and the leading cause of death among US women. Pregnancy is a cardiometabolic “stress test” for women that reveals maternal CVD risk and programs future offspring CVD, but despite its critical importance, CVD risk is not systematically assessed during pregnancy. A new perspective is urgently needed. In 2010, the AHA adopted a bold new focus on ideal cardiovascular health (CVH): optimization of 7 “health factors.” DPM research contributed fundamentally to this shift and subsequent description of patterns, mechanisms, and outcomes of CVH throughout the life course – except during pregnancy and infancy, where data have been lacking. We now have the groundbreaking opportunity to characterize CVH in pregnancy and its associations with outcomes, leveraging stored samples in the extremely well-­phenotyped HAPO cohort. HAPO already includes maternal data on 4 CVH factors: BMI, smoking, blood pressure, and glucose. We propose to add a critical fifth CVH factor by measuring lipids in 950 frozen maternal blood samples, calculate maternal CVH scores, test the hypothesis that better maternal CVH is associated with reduced odds of adverse pregnancy and infant outcomes, and thereby have significant impact on CVH assessment and promotion in pregnancy.