Adverse Pregnancy Outcomes and Early Prediction of Cardiovascular Disease Risk: Vascular and Inflammatory Markers

Background: Women with adverse pregnancy outcomes (APOs) have a 2- to 8-fold increased risk of future atherosclerotic cardiovascular disease (ASCVD), yet the mechanistic pathways are not well-defined. Potential vascular and inflammatory factors contributing to ASCVD are not known in women with a history of preeclampsia (PE) or spontaneous preterm delivery (sPTD). Objective: Describe the vascular and inflammatory factors of women with PE or sPTD and compare differences that may contribute to ASCVD risk. Methods: Women 18 years or older, 2–3 years postpartum, with a history of PE ( N = 19) or sPTD ( N = 13), and reference controls ( N = 19; delivery ≥ 37 weeks’ gestation without APO) were enrolled. All cohorts underwent phlebotomy to measure inflammatory biomarkers and SphygmoCor testing for vascular function, including augmentation index (AIx75), central pulse pressure (CPP), and pulse wave velocity (PWV). Results: Participants with sPTD had higher interleukin-8 concentrations of 6.6 pg/mL (interquartile range [IQR] 5.7, 8.7), compared with 4.7 pg/mL (IQR 2.2, 6.3) in controls ( p = 0.0279). Brachial systolic pressure was higher in PE (120 [standard deviation or SD 12.01]) than in sPTD (110.9 [SD 13.8]) or controls (108.6 [SD 9.22], [ p = 0.0071]). Central systolic pressure was higher in PE (109.8 [SD 11.4]) than in sPTD (99.3 [SD 13.88]) or controls (98.4 [SD 8.94], [ p = 0.0069]). CPP was higher in PE (34.2, SD 3.62) than in sPTD (30.8, SD 3.34) and controls (30.3, SD 3.67 [ p = 0.0027]). Conclusions: Vascular and inflammatory markers in PE or sPTD 2–3 years postpartum are higher compared with reference controls. Future studies should investigate vascular and inflammatory function in larger cohorts and prospectively evaluate contribution to CVD risk.