Abstract P319: Do Pregnancy Complications Elevate Cardiovascular Risk After Pregnancy? An Examination of Cardiometabolic Biomarker and Risk Factor Trajectories Up to the First Nine Months Postpartum in Low Income Women

Abstract

Introduction: Preeclampsia, having a small for gestational age (SGA) baby or preterm delivery are associated with later maternal cardiovascular disease (CVD) risk. Therefore, we sought to examine whether peripartum CVD biomarker and risk factor trajectories differed among women with and without CVD-related pregnancy complications. Methods: In the Maternal Adiposity Metabolism and Stress (MAMAS) Study, we studied n=110 overweight and obese women in the MAMAS study of 8-week mindful eating and stress reduction intervention, we used mixed linear regression analysis to compare trajectories of CVD risk factors at three periods: 1) intrapartum at 12-20 weeks gestation, 2) 3 months postpartum, and 3) 9 months postpartum. CVD biomarkers/ risk factors studied included serum glucose, insulin, HOMA-IR, leptin, ghrelin, lipids, ALT, IL-6, IL-10, tumor necrosis factor, and blood pressure (BP). Covariates for multivariable adjustment included age, maternal smoking, prepregnancy BMI, BP, age*time and prepregnancy BMI*time. Results: Women had mean age =28 y (SD 6), mean prior pregnancies=0.8 (SD 1.0), 13% were White, 36% African American and 32% Latina; n=22 women had one or more CVD-related pregnancy complications. Peripartum glucose and systolic BP trajectories were statistically greater in complicated versus normal pregnancies (p values=0.008 and 0.01 respectively) ( Figure ). Trajectories for lipids, insulin, HOMA-IR, adipokines, ALT, IL-6 and diastolic BP were elevated in complicated versus normal pregnancies, but did not reach statistical significance. Conclusions: Glucose and systolic BP rise were significantly higher from early pregnancy to 9 months postpartum among low income women with complicated vs. uncomplicated pregnancies. Cardiometabolic risk factor modification among women with CVD-related pregnancy complications in the peripartum period may be warranted.