THE PRECAREFEM COHORT: CARDIOVASCULAR AND METABOLIC CHARACTERISTICS IN WOMEN WITH ADVERSE PREGNANCY OUTCOMES WITH A FOCUS ON HYPERTENSIVE DISORDERS OF PREGNANCY AND THEIR OFFSPRING

Objective: In women, traditional and female-specific risk factors for cardiovascular disease are often under-recognized and undertreated. Pregnancy represents a crucial window of opportunity to identify a high-risk population. Adverse pregnancy outcomes, including hypertensive disorders of pregnancy, can help recognize high-risk individuals who may benefit from targeted primary and secondary prevention for CVD and chronic kidney disease (CKD). Design and method: In 2021, the Postpartum Care Outpatient Clinic at the University Hospital St. Pölten, Austria (PreCareFem) was established. Within this clinical program a prospective, open-label, observational cohort was implemented to research cardiovascular and metabolic postpartum biomarkers of women at risk. Results: The PreCareFem Cohort investigates cardiovascular outcomes in women following adverse pregnancy outcomes (APOs), with a focus on hypertensive disorders of pregnancy. Postpartum, women are invited for follow-up at 3 months, 1 year, 2 years, 5 years, and 10 years. A comprehensive panel of clinical outcomes are collected, including pregnancy outcomes, cardiovascular risk assessments, anthropometric data, vascular age, ambulatory blood pressure measurements and outcomes of their offspring. In addition, blood samples to assess transcriptional, epigenetic and metabolic biomarkers are stored at -80°C. As of January 2023, 96 women with a mean age of 31.3 years at delivery were seen for follow-up at 3-6 months postpartum. Among them, 35.4% had a BMI >30 kg/m^2, 56% were nulliparous, and by the 12-month follow-up, 12 of 59 women were diagnosed with new chronic conditions. Conclusions: By integrating clinical care and longitudinal research, the PreCareFem Cohort study aims to investigate the transgenerational course and mechanisms of cardiovascular disease in a high-risk population identified by adverse pregnancy outcomes. This will also inform future cardiovascular prevention strategies in women and their offspring.