Prepregnancy Cardiovascular Health Score and Hypertensive Disorders of Pregnancy

Introduction: Hypertensive disorders of pregnancy (HDP, i.e. preeclampsia, gestational hypertension, eclampsia or HELLP syndrome) are common. Cardiovascular health (CVH) is promoted early in adulthood, yet, suboptimal CVH is increasingly prevalent. The relationship between pre-pregnancy cardiovascular health and the development of HDP is uncertain. Methods: P regnancy O utcomes and P latelet P henot Y pes (POPPY) was a prospective observational cohort study investigating platelet phenotypes during pregnancy, in relation to the development of HDP. Preconception cardiovascular health (CVH) was measured using the American Heart Association’s “Life’s Essential 8” (LE8) metric. Participants completed LE8 lifestyle questionnaires (diet, physical activity, nicotine, sleep) reflecting on health behaviors from immediately prior to pregnancy. Suboptimal CVH was defined as a score <80 in the composite or any individual component score. Results: This study included 61 participants who completed LE8 questionnaires. Of these, 43/61 (70%) had optimal overall CVH, but only 16/51 (27%) had an optimal diet, 36/61 (59%) had optimal sleep duration and 29/61 (48%) had optimal BMI (Figure, panel A). Of those with optimal CVH prior to pregnancy, 6/43 (14%) developed HDP vs 10/18 (56%) of those with suboptimal CVH prior to pregnancy (P=0.002). Those with optimal prepregnancy physical activity levels, sleep health and BMI, had a significantly lower rate of HDP compared to those with suboptimal levels [Figure, panel B]. This was not seen among the other components of CVH. Conclusion: Pregnancies with optimal prepregnancy cardiovascular health had a lower proportion of HDP compared to those with suboptimal CVH. Future studies are needed to evaluate whether optimization of preconception CVH can influence the development of HDP.