loading page

Allostatic Load in Pregnancy, Race and Associations with Subsequent Cardiovascular Related Outcomes: Research Article
  • +12
  • Amir Lueth,
  • Amanda Allshouse,
  • Nathan Blue,
  • william grobman,
  • Lisa Levine,
  • Janet Catov,
  • George Saade,
  • Lynn Yee,
  • Wilson Fernando,
  • Maureen Murtaugh,
  • Noel Merz,
  • JUdith Chung,
  • Mitali Ray,
  • Christina Scifres,
  • Robert Silver (USA)
Amir Lueth
University of Utah

Corresponding Author:[email protected]

Author Profile
Amanda Allshouse
University of Colorado
Author Profile
Nathan Blue
University of Utah Health
Author Profile
william grobman
The Ohio State University
Author Profile
Lisa Levine
Author Profile
Janet Catov
University of Pittsburgh School of Medicine
Author Profile
George Saade
UTMB
Author Profile
Lynn Yee
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago
Author Profile
Wilson Fernando
University of Utah Health
Author Profile
Maureen Murtaugh
University of Utah Health
Author Profile
Noel Merz
Cedars-Sinai Medical Center
Author Profile
JUdith Chung
University of California Irvine
Author Profile
Mitali Ray
University of Pittsburgh
Author Profile
Christina Scifres
Indiana University School of Medicine
Author Profile
Robert Silver (USA)
University of Utah
Author Profile

Abstract

OBJECTIVE To assess the relationship between allostatic load in early pregnancy and CVD, 2 to 7 years postpartum, and potential pathways contributing to racial disparities in CVDs. DESIGN Secondary analysis of an observational cohort study. SETTING nuMom2b Heart Health Study. POPULATION Pregnant individuals. METHODS Our primary exposure was dichotomous high allostatic load in the first trimester, defined as four or more out of 12 biomarkers in the “worst” quartile. The primary outcome was new diagnosis of composite CVD, consisting of HTN and or MD (fasting glucose greater than 100 mg/dL or medication for diabetes). Each outcome and allostatic load component was analyzed secondarily. Multivariable logistic regression was used to test the association between high allostatic load and CVD adjusted for potential confounders. Mediation and moderation analyses assessed the role of high allostatic load in racial disparities of CVD. MAIN OUTCOME MEASURE Composite CVD. RESULTS Among 4,022 individuals, CVD was identified in 1,462 (36.4%); 26.6% had HTN, and had 15.4% MD. High allostatic load was present in 33.0%. After adjustment for covariates, high allostatic load was associated with CVD (aOR 2.0, 1.8-2.3), HTN (2.1, 1.8-2.4), and MD (1.7, 1.5-2.1). There was a reduction in the magnitude of the relationship between race and CVD with the addition of allostatic load. Self-reported race did not significantly moderate the relationship between allostatic load and CVD. CONCLUSION High allostatic load is associated with CVD. Allostatic load was a partial mediator between race and CVD. Race did not moderate the relationship between allostatic load and CVD.
27 Oct 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
17 Nov 2022Submission Checks Completed
17 Nov 2022Assigned to Editor
17 Nov 2022Review(s) Completed, Editorial Evaluation Pending
19 Nov 2022Reviewer(s) Assigned
03 Jan 2023Editorial Decision: Revise Major
03 Feb 20231st Revision Received
06 Feb 2023Submission Checks Completed
06 Feb 2023Assigned to Editor
06 Feb 2023Review(s) Completed, Editorial Evaluation Pending
06 Feb 2023Reviewer(s) Assigned
24 Feb 2023Editorial Decision: Revise Major
17 Mar 20232nd Revision Received
20 Mar 2023Assigned to Editor
20 Mar 2023Submission Checks Completed
20 Mar 2023Review(s) Completed, Editorial Evaluation Pending
22 Mar 2023Editorial Decision: Accept