Abstract P197: Structural and Functional Arterial Changes in Healthy Women Following Pregnancy

Abstract

Background: Parity is associated with future maternal cardiovascular disease (CVD) risk in a J-shaped fashion. Markers of vascular aging and future CVD risk, such as common carotid artery intima-media thickness (CCA IMT) and inter-adventitial diameter (IAD), increase acutely during pregnancy. As reported previously, increased CCA IMT did not recede in the early postpartum period. This study aims to determine whether vascular changes during pregnancy persist beyond the initial postpartum period. Methods: This study is a follow-up to a prospective study that assessed vascular health in a cohort of 43 healthy women during a first pregnancy and at 6-8 weeks postpartum. Data on physical measures, biomarker assays, pregnancy outcomes, health history and CCA IMT and IAD via B-mode ultrasound were collected at a second post-partum visit 1-5 years following the index birth. Paired t-tests and multivariable linear regression were used to assess changes in vascular measures. Results: Sixteen participants with mean±SD age 32.4±4.4 years, BMI 25.6±3.1 kg/m 2 , cumulative breastfeeding time of 19.7±11.2 months and time from index delivery of 2.7±0.8 years completed the second postpartum visit. Eight of these women had ≥ 1 subsequent births. Compared to the third trimester, the decrease in IAD and increase in IMT observed early postpartum, persisted further out postpartum (figure). At the second postpartum visit, larger IAD was associated with higher blood pressure whereas thicker IMT was associated with less time since index birth, greater weight gain, shorter duration of breastfeeding, and lower insulin resistance (all p<0.05). Conclusions: Markers of vascular aging did not consistently improve 1 to 5 years after delivery. Persistence of pregnancy related vascular effects suggest a possible mechanism linking increased CVD risk with parity. Prolonged breastfeeding and weight management following pregnancy may be modifiable lifestyle factors affecting future maternal CVD risk.