Individuals who experience an adverse pregnancy outcome (APO; hypertensive disorder of pregnancy, gestational diabetes, preterm birth) have a lifetime of excess cardiovascular disease (CVD) risk. However, traditional CVD risk factors are not usually at threshold levels in the years soon after delivery. Arterial stiffness and wave reflection, sensitive measurements that provide information about how pulses travel through the body, may identify emerging and potentially reversible CVD in people with APO histories. 

The aims of the study are to characterize and compare arterial stiffness and wave reflection 8-16 years after pregnancy among women with versus without an APO. We will account for patterns in lifestyle behaviors and APO types in additional analyses to identify specific targets and timing for interventions. We will determine whether antiangiogenic or inflammatory biomarker levels measured in early pregnancy are associated with poorer arterial stiffness and wave reflection 8-16 years after delivery in participants with and without a history of APO. The study is being conducted in the nuMoM2b HHS cohort at 5 medical campuses in the US.