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

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.