Identifying cardiovascular health profiles in early pregnancy: A "Life's Essential 8"-based approach to assessing risk of hypertensive disorders of pregnancy.

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-10-07 DOI:10.1016/j.preghy.2025.101260

Chelsea A DeBolt, Rebecca M Cohen, Zhan Zhao, Katharine McCarthy, Kimberly B Glazer

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引用次数: 0

Abstract

Objectives: This study aimed to characterize cardiovascular risk profiles in an obstetric population using American Heart Association's Life's Essential 8 components and investigate which combinations are associated with hypertensive disorders of pregnancy (HDP).

Study design: Secondary analysis of a prospective observational cohort, Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b).

Main outcome measures: We used latent class analysis to identify cardiovascular risk classes using Life's Essential 8 indicators at 6-14 weeks' gestation: blood pressure (BP), body mass index (BMI), and self-reported diet, sleep, smoke exposure, and physical activity. We assessed predictors of class membership and odds of HDP with logistic regression.

Results: We identified a four-class solution with the following interpretative labels: (1) Healthy Behaviors/Normal BMI & BP (42%), (2) No Physical Activity/Normal BMI & BP (31%), (3) High Snoring/Elevated BMI (18%), and (4) Poor Behaviors/Normal BMI & BP (8%). Compared with the Healthy Behaviors/Normal BMI & BP class, individuals in the other risk profiles were more likely to be unmarried vs. married, Non-Hispanic Black vs. Non-Hispanic White, have government vs. commercial insurance, and report high vs. low periconceptual stress. Two risk profiles were associated with HDP: High Snoring/Elevated BMI had 2.4 times (95% CI 2.1-2.8) the odds and Poor Behaviors/Normal BMI & BP had 1.5 times (95% CI 1.2-1.8) the odds of HDP compared with Healthy Behaviors/Normal BMI & BP.

Conclusions: Two cardiovascular risk profiles-High Snoring/Elevated BMI and Poor Behaviors/Normal BMI & BP-were linked to HDP, emphasizing the potential for personalized, multifactorial interventions targeting modifiable behaviors to reduce risk.

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确定妊娠早期的心血管健康状况：一种基于“生命基本”的方法来评估妊娠期高血压疾病的风险

目的：本研究旨在使用美国心脏协会的生命基本8项成分来描述产科人群的心血管风险概况，并调查哪些组合与妊娠高血压疾病（HDP）相关。研究设计：对一项前瞻性观察队列的二次分析，“未分娩妊娠结局研究：监测准妈妈（nuMoM2b）”。主要结果测量：我们使用潜在类别分析来确定心血管风险类别，使用妊娠6-14周的生命基本8指标：血压（BP）、体重指数（BMI）、自我报告的饮食、睡眠、吸烟暴露和身体活动。我们用逻辑回归评估了班级成员和HDP几率的预测因子。结果：我们确定了四类解决方案，并给出了以下解释性标签：(1)健康行为/正常BMI和BP(42%),(2)无体育活动/正常BMI和BP(31%),(3)打鼾/ BMI升高（18%），(4)不良行为/正常BMI和BP（8%）。与健康行为/正常BMI和BP类别相比，其他风险概况的个体更可能是未婚vs已婚，非西班牙裔黑人vs非西班牙裔白人，有政府保险vs商业保险，并报告高与低的围孕期压力。两种风险特征与HDP相关：与健康行为/正常BMI和BP相比，高打鼾/ BMI升高的几率是HDP的2.4倍（95% CI 2.1-2.8），不良行为/正常BMI和BP的几率是HDP的1.5倍（95% CI 1.2-1.8）。结论：高打鼾/ BMI升高和不良行为/ BMI和bp正常这两种心血管风险与HDP有关，强调了针对可改变行为的个性化、多因素干预以降低风险的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health OBSTETRICS & GYNECOLOGYPERIPHERAL VASCULAR-PERIPHERAL VASCULAR DISEASE

CiteScore

4.90

自引率

0.00%

发文量

127

期刊介绍： Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field. We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.