Project 467015

Cardiovascular disease (CVD) is the leading cause of death in Canadian women. Weight gain between pregnancies is an essential predictor of a womans lifelong health. By her next pregnancy, a woman is more susceptible to having cardiometabolic (CM) dysfunction, preeclampsia, gestational diabetes mellitus (GDM), stillbirth, and preterm birth. It is known that a woman who gives birth to a child who was affected by prematurity, a congenital disability, major morbidity, or death, is more likely to experience stress and self-neglect than a woman whose child was unaffected by one of these conditions. Yet, little is known about how a womans CM profile changes or worsens between pregnancies among first-time mothers as a result of this stress. Information about a womans CM profile in her second pregnancy may provide novel interventions that can reduce the progression of CM dysfunction, and the development of overt CVD. The cohort will involve 600,000 women aged 15-49 years in Ontario, Canada who had two consecutive single-infant births from 2007-2021. We will compare women with and without exposure to the 5 aforementioned early stressful childhood challenges. CM measures assessed at the start of the second pregnancy will be interpregnancy weight difference, diabetes mellitus (DM), chronic hypertension (cHTN) (high blood pressure) and dyslipidemia (unfavourable lipid profile). The proposed study will illuminate the link between adverse perinatal/child outcomes in a first pregnancy and indicators of CM dysfunction at a subsequent pregnancy, offering important early opportunities to lower a womans risk of CVD in the years that follow.