Preconception Cardiometabolic Markers and Birth Outcomes Among Women in the Hispanic Community Health Study/Study of Latinos

<strong><em>Background:</em></strong> Associations between preconception cardiometabolic markers and birth outcomes have been noted, but data are scarce for Hispanics/Latinos. We examined the association between preconception cardiometabolic markers, birthweight and preterm birth among U.S. Hispanic/Latina women. <strong><em>Materials and Methods:</em></strong> The Hispanic Community Health Study/Study of Latinos is a cohort study of U.S. adults 18-74 years of age, including 3,798 women of reproductive age (18-44 years) from four field centers representing Hispanic/Latino backgrounds of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American. A baseline clinic examination (2008-2011) and a second clinic examination (2014-2017), including ascertainment of birth outcomes, allowed for identification of 517 singleton live births between the exams. Preconception cardiometabolic markers included abdominal obesity (waist circumference &ge;88&thinsp;cm), body mass index &gt;30&thinsp;kg/m², high blood pressure (systolic &ge;120&thinsp;mmHg and diastolic &ge;80&thinsp;mmHg), elevated triglycerides (&ge;150&thinsp;mg/dL), low high-density lipoprotein cholesterol (&lt;50&thinsp;mg/dL), elevated fasting glucose (&ge;100&thinsp;mg/dL), and insulin. Complex survey linear regression modeled the association between cardiometabolic markers and birthweight-for-gestational age <em>z</em>-score; complex survey logistic regression modeled the association with preterm birth. Analyses adjusted for Hispanic/Latina background, field center, years between baseline and birth, age, and nulliparity. <strong><em>Results:</em></strong> In adjusted linear regression models, elevated fasting glucose was associated with higher birthweight <em>z</em>-scores (&beta;&thinsp;=&thinsp;0.56, 95% confidence interval [95% CI] 0.14 to 0.99), even after further adjustment for maternal percent body fat (&beta;&thinsp;=&thinsp;0.53, 95% CI 0.10 to 0.95). In adjusted logistic regression models, high blood pressure (odds ratio [OR]&thinsp;=&thinsp;2.57, 95% CI 1.13 to 5.88) and increased insulin (OR&thinsp;=&thinsp;1.50, 95% CI 1.06 to 2.14, for a 10&thinsp;mU/L increase) were associated with higher odds for preterm birth. <strong><em>Conclusions:</em></strong> Infant birthweight and preterm birth may be influenced by selected cardiometabolic risk factors before pregnancy among Hispanic/Latina women.