Cardiovascular health in pregnancy according to Life’s Essential 8 score

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular health (n=3580). Intervention: Pregnancy vs. Non-pregnant women. Primary outcome: Ideal cardiovascular health (Life's Essential 8 score ≥80) (OR 0.49, 95% CI 0.31-0.77).

Q: What does this research mean for the field?

Pregnant women are 51% less likely to have ideal cardiovascular health compared to non-pregnant women, as measured by the Life's Essential 8 score. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Krishin Yerabolu; HARSHVIR BAL; Abdulla Shahid; Nehal Vekariya; Naman S. Shetty; Mokshad Gaonkar; Nirav Patel; Peng Li; Pankaj Arora; Garima Arora

doi:10.1038/s44325-026-00117-6

April 1, 2026npj Cardiovascular HealthOpen Access

Cardiovascular health in pregnancy according to Life’s Essential 8 score

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Key result

Pregnancy linked to ~51% lower likelihood of ideal cardiovascular health versus non-pregnant women.

OR 0.49
95% CI 0.31-0.77
n=3,580

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Why the study?

Cardiovascular disease is a leading cause of mortality among pregnant women in the US.

Does pregnancy status affect cardiovascular health as measured by the Life's Essential 8 score in women aged 20-44 years?

Key Points

To assess and compare cardiovascular health among pregnant and non-pregnant reproductive-aged women without cardiovascular disease using the Life’s Essential 8 framework.
Analyzed NHANES survey cycles from 2011 to March 2020, evaluating 3,580 women aged 20–44 years without a history of cardiovascular disease (171 pregnant and 3,409 non-pregnant).
Calculated cardiovascular health based on Life’s Essential 8 metrics, which encompass diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure.
Pregnant women had lower mean Life’s Essential 8 scores compared to non-pregnant women [69.3(1.2) vs. 72.3(0.4)] and were 51% less likely to achieve ideal cardiovascular health [ORadj: 0.49 (95%CI: 0.31–0.77)].
Expectant women demonstrated significantly lower odds of ideal physical activity [ORadj: 0.47 (95% CI: 0.31–0.71)], blood lipids [ORadj: 0.39 (95% CI: 0.26–0.58)], and BMI [ORadj: 0.42 (95% CI: 0.25–0.69)], but higher odds of ideal blood pressure [ORadj: 2.07 (95% CI: 1.02–4.22)].
Among pregnant participants, mean Life’s Essential 8 scores decreased from 71.0 (2.2) in 2011–2012 to 66.4 (1.5) in 2017–2020.

Study Design

Type

Cross-Sectional (n=3,580)

Structured PICO

Does pregnancy status affect cardiovascular health as measured by the Life's Essential 8 score in women aged 20-44 years?

P

Population

3,580 women aged 20-44 years without a history of cardiovascular disease from the 2011-2020 NHANES data, including 171 pregnant women (representing 1.6 million US women) and 3,409 non-pregnant women (representing 34.5 million US women).

I

Intervention

Pregnancy status (pregnant women)

C

Comparator

Non-pregnant women

O

Outcome

Cardiovascular health assessed using the Life's Essential 8 (LE8) scorecomposite

Main Result

Effect estimate: OR 0.49 (95% CI 0.31-0.77)

Pregnant women in the US have significantly lower cardiovascular health scores compared to non-pregnant women, driven primarily by poorer physical activity, blood lipids, and BMI.

Limitations

Lack of data on gestational age
No oral glucose tolerance test using pregnancy-specific modifications
Cross-sectional nature does not permit inference of causality
Self-reported data susceptible to recall bias and measurement errors
Exclusion of women with missing data
Limited sample size of pregnant women preventing secular trend analysis
NHANES does not include gestational age data, preventing differentiation between early and late pregnancy
Blood sugar was assessed using fasting glucose or HbA1c without oral glucose tolerance testing, which may not adequately capture pregnancy-related insulin resistance
Sleep was evaluated based solely on duration, without accounting for fragmentation or poor sleep quality
Dietary intake was based on single 24-h recalls, which may not reflect habitual intake and are subject to reporting bias
Small sample size of pregnant women per cycle limited formal statistical testing of secular trends

Implication

Warrants CV health optimization during pregnancy; leaves open causality and impact of targeted interventions.

Abstract

Cardiovascular disease (CVD) is a leading cause of mortality among pregnant women in the United States (US). This study assessed cardiovascular health (CVH) using the Life’s Essential 8 (LE8) score, which includes sleep, in a nationally representative sample of pregnant women aged 20–44 years without CVD using the 2011–2020 NHANES data. The cohort included an estimated 1.6 million pregnant and 34.5 million non-pregnant women. Pregnant women had lower mean LE8 scores [69.3(1.2) vs. 72.3(0.4)], physical activity [42.7(3.9) vs. 56.2(1.3)], blood lipids [61.8(3.4) vs. 79.4(0.6)], BMI [54.4(3.2) vs. 60.5(1.0)], and diet [43.7(2.5) vs. 43.8(0.7)] than non-pregnant women. They were 51% less likely to have ideal CVH [OR adj : 0.49 (95%CI: 0.31–0.77)]. The mean LE8 score in pregnant women was 71.0 (2.2) in 2011–2012 and 66.4 (1.5) in 2017–2020.

Discussion

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Cite This Study

Yerabolu et al. (2026) conducted a cross-sectional in Cardiovascular health (n=3,580). Pregnancy vs. Non-pregnant women was evaluated on Ideal cardiovascular health (Life's Essential 8 score ≥80) (OR 0.49, 95% CI 0.31-0.77). Pregnant women were 51% less likely to have ideal cardiovascular health compared to non-pregnant women (OR 0.49).

synapsesocial.com/papers/69cf5f645a333a821460e7d9 https://doi.org/10.1038/s44325-026-00117-6

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Cardiovascular health in pregnancy according to Life’s Essential 8 score

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Cardiovascular health in pregnancy according to Life’s Essential 8 score

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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