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April 3, 2026npj Cardiovascular Health1 citationsOpen Access

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

KYKrishin YeraboluHBHARSHVIR BALASAbdulla Shahid

Key Result

Pregnant women were 51% less likely to have ideal cardiovascular health compared to non-pregnant women (OR 0.49).

Key Points

  • The research aims to evaluate the cardiovascular health of pregnant women using the Life’s Essential 8 score.
  • Analyzed NHANES data from 2011-2020
  • Compared cardiovascular health scores of pregnant vs non-pregnant women
  • Calculated odds of having ideal cardiovascular health based on parameters
  • Pregnant women had a lower mean Life's Essential 8 score compared to non-pregnant women
  • Only 49% of pregnant women achieved ideal cardiovascular health
  • Mean LE8 score dropped from 71.0 in 2011-2012 to 66.4 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

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.

Main Result

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

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

Abstract

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.

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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/69cf5f645a333a821460e7d9https://doi.org/10.1038/s44325-026-00117-6
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