Preconception cardiometabolic markers and odds of developing adverse pregnancy outcomes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Background: Adverse pregnancy outcomes (APO) are associated with increased cardiovascular disease (CVD) risk. However, studies evaluating preconception cardiometabolic risk factors and the development of APO are lacking in high-risk, understudied groups including the Hispanic/Latina population. Methods: We examined the odds of APO associated with preconception cardiometabolic markers in the prospective cohort of Hispanic Community Health Study/Study of Latinos (HCHS/SOL). APO was defined as self-reported hypertensive disorders of pregnancy (HDP) or gestational diabetes (GDM). Metabolic syndrome was defined per NCEP-ATP III criteria. Women reporting at least 1 pregnancy between baseline (2008-2011) and visit 2 (2014-2017) were included. Multivariate logistic regressions were used to determine the odds of APO. Results: Among 529 participants, 111 (21 %) reported an APO. In adjusted models, higher preconception systolic blood pressure (SBP), body mass index, waist circumference, HbA1c, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were associated with increased odds of APO. A dose-response relationship in metabolic syndrome components, with two and three or more components significantly increasing the odds of developing an APO (adjusted OR 2.50 (1.07, 5.84) and 3.39 (1.37, 8.42)). Conclusion: High-risk preconception cardiometabolic abnormalities increase the odds of developing an APO in Hispanic/Latina women, with a dose-response relationship by the number of metabolic syndrome components. Early identification and intervention are crucial to reduce APOs and their long-term cardiovascular consequences in this population.