Objective:

To examine the association between a modified Life’s Essential 8 (mLE8) score measured during pregnancy and incident cardiometabolic disease over 7 years of follow-up.

Approach:

• Study Design: The study utilized a racially diverse, low-income cohort from South Carolina, examining participants from the Cradle randomized trial of group prenatal care.
• Eligibility Criteria: Participants aged 14 to 45 years with a singleton pregnancy were included, while those with major medical comorbidities were excluded.
• Data Collection: Demographic, lifestyle, and stress surveys were completed at enrollment and during the third trimester, alongside biospecimen collection.
• mLE8 Scoring: Cardiovascular health during pregnancy was assessed using a modified LE8 score that excluded non-HDL cholesterol due to unavailability in most participants.
• Follow-Up: Follow-up began 7 days after delivery to assess the incidence of cardiometabolic disease.

Key Findings:

• Higher mLE8 scores were associated with a longer time to incident cardiometabolic disease after delivery.
• Traditional cardiovascular risk calculators are not well-suited for reproductive-aged women due to exclusion of pregnancy-related factors.

Interpretation:

The role of the mLE8 as a proactive risk stratification tool for long-term maternal cardiometabolic health remains to be determined.

Limitations:

• The study primarily focused on a specific cohort, which may limit generalizability.
• Existing studies have largely been cross-sectional, with limited prospective data on maternal outcomes.

Conclusion:

The study aims to clarify the role of mLE8 in identifying individuals at risk for later cardiometabolic disease during pregnancy.