biostudies-literatureHarville EWTampereen TuberkuloosisäätiöEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHD NIH HHSSigne ja Ane Gyllenbergin SäätiöNIA NIH HHSYrjö Jahnssonin SäätiöSuomen KulttuurirahastoNational Heart, Lung, and Blood InstituteNHLBI NIH HHSNational Institute on AgingAcademy of FinlandSydäntutkimussäätiöEuropean Research CouncilJuho Vainion SäätiöEmil Aaltosen SäätiöPaavo Nurmen Säätiö168-179https://www.ebi.ac.uk/biostudies/studies/S-EPMC10782826biostudies-literatureUnknown38(3)<h4>Background</h4>Life course patterns of change in risk-trajectories-affect health.<h4>Objectives</h4>To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes.<h4>Methods</h4>Data from two cohort studies participating in the International Childhood Cardiovascular Consortium-The Bogalusa Heart Study (BHS; started in 1973, N = 903 for this analysis) and the Cardiovascular Risk in Young Finns Study (YFS; started in 1980, N = 499) were used. Both followed children into adulthood and measured cardiovascular risk factors, including body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP), total, lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol and serum triglycerides. Discrete mixture modelling was used to divide each cohort into distinct trajectories according to these risk factors from childhood to early adulthood, and these groups were then used to predict pregnancy outcomes including small for gestational age (SGA; <10th study-specific percentile of gestational age by sex), preterm birth (PTB; <37 weeks' gestation), hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with control for age at baseline and at first birth, parity, socioeconomic status, BMI and smoking.<h4>Results</h4>The models created more trajectories for BMI, SBP and HDL-cholesterol in the YFS than in BHS, for which three classes generally seemed to be sufficient to represent the groups in the population across risk factors. In BHS, the association between the higher and flatter DBP trajectory and PTB was aRR 1.77, 95% confidence interval [CI] 1.06, 2.96. In BHS the association between consistent total cholesterol and PTB was aRR 2.16, 95% CI 1.22, 3.85 and in YFS the association between elevated high trajectory and PTB was aRR 3.35, 95% CI 1.28, 8.79. Elevated-increasing SBP was associated with a higher risk of GH in BHS and increasing or persistent-obese BMI trajectories were associated with GDM in both cohorts (BHS: aRR 3.51, 95% CI 1.95, 6.30; YFS: aRR 2.61, 95% CI 0.96, 7.08).<h4>Conclusions</h4>Trajectories of cardiovascular risk, particularly those that represent a consistent or more rapid worsening of cardiovascular health, are associated with a higher risk of pregnancy complications.Paediatric and perinatal epidemiologyTrajectories of cardiovascular risk predict pregnancy outcomes: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study.PMC10782826338395256474314389R01 AG016592255381141071126925R01 HD069587330809RF1 AG041200320297322098129378742927P50 HL015103134309124282R01 AG041200121584R01 HD032194283115117797104821319060286284Hakala JOPahkala KLehtimaki TRovio SPHarville EWRaitakari OfalseTrajectories of cardiovascular risk predict pregnancy outcomes: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study.<h4>Background</h4>Life course patterns of change in risk-trajectories-affect health.<h4>Objectives</h4>To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes.<h4>Methods</h4>Data from two cohort studies participating in the International Childhood Cardiovascular Consortium-The Bogalusa Heart Study (BHS; started in 1973, N = 903 for this analysis) and the Cardiovascular Risk in Young Finns Study (YFS; started in 1980, N = 499) were used. Both followed children into adulthood and measured cardiovascular risk factors, including body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP), total, lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol and serum triglycerides. Discrete mixture modelling was used to divide each cohort into distinct trajectories according to these risk factors from childhood to early adulthood, and these groups were then used to predict pregnancy outcomes including small for gestational age (SGA; <10th study-specific percentile of gestational age by sex), preterm birth (PTB; <37 weeks' gestation), hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with control for age at baseline and at first birth, parity, socioeconomic status, BMI and smoking.<h4>Results</h4>The models created more trajectories for BMI, SBP and HDL-cholesterol in the YFS than in BHS, for which three classes generally seemed to be sufficient to represent the groups in the population across risk factors. In BHS, the association between the higher and flatter DBP trajectory and PTB was aRR 1.77, 95% confidence interval [CI] 1.06, 2.96. In BHS the association between consistent total cholesterol and PTB was aRR 2.16, 95% CI 1.22, 3.85 and in YFS the association between elevated high trajectory and PTB was aRR 3.35, 95% CI 1.28, 8.79. Elevated-increasing SBP was associated with a higher risk of GH in BHS and increasing or persistent-obese BMI trajectories were associated with GDM in both cohorts (BHS: aRR 3.51, 95% CI 1.95, 6.30; YFS: aRR 2.61, 95% CI 0.96, 7.08).<h4>Conclusions</h4>Trajectories of cardiovascular risk, particularly those that represent a consistent or more rapid worsening of cardiovascular health, are associated with a higher risk of pregnancy complications.2024-01-01T00:00:00Z2024 Mar2025-04-04T09:09:54.01Z2025-04-04T09:09:54.01ZS-EPMC107828263743254910.1111/ppe.12995