Association Between Adverse Pregnancy Outcomes and Awareness of Cardiovascular Risk Factors: A nuMoM2b-HHS Secondary Analysis

Authors

• Elizabeth M. Wendl, University of Utah School of Medicine
• Amanda A. Allshouse, University of Utah School of Medicine
• Ashley Goodwin, University of Utah School of Medicine
• Bri Hobbs, Intermountain Healthcare
• Philip Greenland, Northwestern Feinberg School of Medicine
• Lisa Levine, Perelman School of Medicine at the University of Pennsylvania
• William Grobman, Warren Alpert School of Medicine at Brown University
• George R. Saade, Macon & Joan Brock Virginia Health Sciences at Old Dominion UniversityFollow
• Natalie Cameron, Northwestern Feinberg School of Medicine
• C. Noel Bairey Merz, Cedars-Sinai Medical Center
• Caroline Rouse, Indiana University School of Medicine
• Sarah Rogan, University of Pittsburgh Magee-Womens Hospital
• Judith H. Chung, University of California-Irvine
• Lauren H. Theilen, University of Utah School of Medicine
• National Heart, Lung, and Blood Institute nuMoM2b Heart Health Study Network

Document Type

Article

Publication Date

2025

DOI

10.1002/pmf2.70092

Publication Title

Pregnancy

Volume

1

Issue

5

Pages

e70092

Abstract

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure was APO during index pregnancy: hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, small-for-gestational age, and stillbirth. The primary outcome is a composite of participant awareness of a CRF diagnosis (participant-reported or prescription medication-treated). Unadjusted and adjusted logistic regression models estimated associations between exposure and outcome.

Results

Among 980 participants, 77% had one CRF, 20% had two, and 3% had three. The most common CRF was hypertension (51%) and 35% of participants had an APO. Participant awareness of their CRF diagnosis was only 22% (220/980)-26% with an APO versus 20% without (p = 0.04). After multivariable adjustment, history of APO was not associated with participant awareness of CRFs.

Conclusion

Only 22% of the participants with a CRF reported knowing about or being treated for their CRF. Participants with and without an APO did not statistically differ in awareness of their CRFs 2-7 years after their first pregnancy.

Rights

© 2025 The Authors

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Original Publication Citation

Wendl, E. M., Allshouse, A. A., Goodwin, A., Hobbs, B., Greenland, P., Levine, L., Grobman, W., Saade, G. R., Cameron, N., Merz, C. N. B., Rouse, C., Rogan, S., Chung, J. H., & Theilen, L. H. (2025). Association between adverse pregnancy outcomes and awareness of cardiovascular risk factors: A nuMoM2b-HHS secondary analysis. Pregnancy, 1(5), Article e70092. https://doi.org/10.1002/pmf2.70092

Repository Citation

Wendl, E. M., Allshouse, A. A., Goodwin, A., Hobbs, B., Greenland, P., Levine, L., Grobman, W., Saade, G. R., Cameron, N., Merz, C. N. B., Rouse, C., Rogan, S., Chung, J. H., & Theilen, L. H. (2025). Association between adverse pregnancy outcomes and awareness of cardiovascular risk factors: A nuMoM2b-HHS secondary analysis. Pregnancy, 1(5), Article e70092. https://doi.org/10.1002/pmf2.70092