Adverse pregnancy outcomes partly mediate association between prepregnancy obesity, cardiovascular disease risk

Adverse pregnancy outcomes (APOs) mediate a small proportion of the association between prepregnancy obesity and cardiovascular disease (CVD) risk in midlife, according to a study published in the April 22 issue of the Journal of the American College of Cardiology . Jaclyn D. Borrowman, Ph.

D., from Northwestern University in Chicago, and colleagues examined the extent to which prepregnancy body mass index (BMI) and CVD risk factors in midlife are mediated by APOs in a study involving 4,269 pregnant participants, aged 18 years or older, enrolled at 28 weeks of gestation without prepregnancy hypertension or diabetes. At 11.



6 ± 1.3 years after delivery, participants had a follow-up visit. Overall, gestational diabetes mellitus (GDM) and new-onset hypertensive disorders of pregnancy (HDP) occurred in 13.

8 and 10.7% of participants, respectively. The researchers found that those with prepregnancy obesity had higher mean arterial pressure (7.

0 mm Hg), triglycerides (28.5 mg/dL), and hemoglobin A1c (0.3%) at follow-up compared with those with a normal prepregnancy BMI.

The association between obesity and hemoglobin A1c was partially mediated by GDM (24.6%), while the association between obesity and mean arterial pressure was partially mediated by new-onset HDP (12.4%).

"These data suggest that APOs represent a clinically significant marker of future CVD risk that is unmasked during the stress of pregnancy and highlights key vascular and metabolic pathways , which has important implications in designing preventive strategies," the authors write. More information: Jaclyn D. Borrowman et al, Prepregnancy Adiposity, Adverse Pregnancy Outcomes, and Cardiovascular Disease Risk in Midlife, Journal of the American College of Cardiology (2025).

DOI: 10.1016/j.jacc.

2025.02.033 Garima Sharma et al, Maternal Obesity and Adverse Pregnancy Outcomes as Mediators of Cardiovascular Disease Risk in Midlife, Journal of the American College of Cardiology (2025).

DOI: 10.1016/j.jacc.

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