Abstract P170: Cardiovascular Health Scores, Adverse Pregnancy Outcomes, And Angiogenic Biomarkers Associated With Cognition8-10 Years After Pregnancy

Abstract

Introduction: Women with adverse pregnancy outcomes (APO, preeclampsia, preterm birth, small for gestational age neonates), especially those with placental maternal vascular malperfusion (MVM), are at increased cardiovascular and cognitive risk, perhaps due to poor cardiovascular health (CVH) and other vascular pathology. Hypothesis: Including history of APO and MVM in CVH scores identifies women with lower cognitive function and circulating angiogenic biomarker profiles indicating ongoing vascular pathophysiology. Methods: CVH was evaluated in 39 women 8-10 years after pregnancy (mean age 39.8 ±6 years, 36% Black) using standard metrics (smoking, BMI, blood pressure, total cholesterol, fasting glucose, and physical activity; higher score is healthier). APO history was abstracted from the medical record and added to CVH (no APO [n=14], APO-MVM [n=13], APO+MVM [n=13] to create a CVH-APO score. We evaluated cognitive function (memory, processing speed and executive function) as domain z scores using standard tests. Angiogenic biomarkers (VEGF-A, VEGF-C, VEGF-D, Tie-2, sFlt1, PlGF, and bFGF) were quantified using Angiogenesis Panel 1 (Meso Scale Diagnostics). Associations of CVH with cognition and biomarkers were evaluated using Pearson correlations. CVH groups (poor [CVH ≤7] vs. healthy [CVH >8) were compared with and without APO history using t-test. Results: Women with APO+MVM had lower CVH scores compared to those with no APO, adjusted for age and race (-1.5, p=0.03). Poor CVH was associated with slower processing speed (r=0.350, p=0.031) and reduced executive function (r=0.353, p=0.03) but not memory. When APO history was added to CVH, associations became stronger (r=0.402, p=0.012 for processing speed; 0.422, p=0.008 for executive function). Poorer CVH scores also correlated with higher VEGF A (-0.501 p=0.001), VEGF C (-0.653, p<0.001), PlGF (-0.326 p=0.045), and bFGF (-0.383, p=0.018). Using the combined CVH-APO score, women with poor CVH (n=18) compared to healthy CVH (n=20) had higher bFGF (18 vs 9.5 pg/mL p=0.013), VEGF-A (78 vs 44pg/mL p=0.002) and VEGF-C (1319 vs 828 p=0.023). Discussion: Poor CVH is associated with lower cognition and higher circulating angiogenic biomarker profiles in women, and APO history may further contribute to the cumulative vascular pathophysiological burden a decade after pregnancy.