Scoping Review on the Impact of Pregnancy on Brain Health: Influence of the American Heart Association's Life's Essential 8

Background: Brain health has traditionally been studied in late life and has focused on conditions such as Alzheimer’s disease and vascular cognitive impairment. Recent research has increasingly shifted towards understanding preventable or modifiable early-life factors for brain health, especially vascular risks such as those included in the American Heart Association’s Life’s Essential 8 (LE8). Objective: The present study will undertake a scoping review of research to investigate the relationship between the 7 or 8 components of cardiovascular health (American Heart Association’s “Life’s Simple 7 [LS7]” or “Life’s Essential 8”, respectively) during pregnancy and its relation to maternal brain health in mid to late life. Design: Following the guidance provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this scoping review will be registered on Prism by Northwestern University Feinberg School of Medicine. Online databases will be used to identify papers published from 2010-2024 as LS7 or LE8. The papers will also be peer-reviewed ones, from English language journal articles, and measure at least one component of LS7 or LE8 during pregnancy in relation to mid to late life brain health outcomes. The research team developed search terms in collaboration with a research librarian, and the search will be performed in November 2024. Four or more reviewers will independently screen the titles and abstracts of the publications that are identified by our search strategy, select articles based on our eligibility criteria, and those articles that are initially selected articles will then be retrieved and undergo a full-text review by an oversight team to determine eligibility. Results: We anticipate that the components of LS7 and LE8 will provide associations between cardiovascular risks in pregnancy and subsequent maternal brain health later in life. However, we expect that there will be limited information in relation to some of the cardiovascular risk factors which will be identified through our scoping review exercise, whereby we will then be able to emphasize gaps in scientific knowledge in relation to these factors. Conclusion: We will carry out a scoping review to determine available knowledge in relation to the occurrence of well-known cardiovascular risks during pregnancy, and the influence of the cardiovascular risks on maternal brain health later in life. In addition, we will identify gaps in knowledge in relation to the cardiovascular risks in pregnancy and their potential influence on brain health.