Association between adverse pregnancy outcomes and awareness of cardiovascular risk factors: A nuMoM2b‐HHS secondary analysis

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.