Abstract TP247: Adverse Pregnancy Outcomes and MRI Markers of Cerebral Small Vessel Disease

Introduction: Adverse pregnancy outcomes (APOs) are early indicators of long-term cerebrovascular risk. Studies suggest links between APOs and early cerebral small vessel disease (CSVD), but few prospective studies have investigated the association. The ongoing nuMoM2b Heart Health Study (nuMoM2b HHS) has followed >5000 women since 2010–2014, early in their first pregnancies. Objective: To investigate associations between APOs and MRI markers of CSVD: enlarged perivascular spaces (PVS) and silent brain infarcts (SBI), in nuMoM2b HHS participants. Methods: 3T brain MRI scans were acquired from stroke-free nuMoM2b HHS participants at two clinical sites between December 2022 - June 2024. Clinical data, pregnancy history were obtained through surveys with confirmation by medical chart abstraction. The primary exposure was one or more of the following APOs in any pregnancy: hypertensive disorders of pregnancy, preterm birth, fetal growth restriction, stillbirth, or small for gestational age infant. MRI markers of CSVD were manually reviewed. Enlarged PVS were defined as