Prevention & lipids

Prepregnancy Cardiovascular Health, Gestational Diabetes, and Coronary Artery Calcium

JAMA CardiolPublished Prospective cohort study

Main finding · Incident CACResult — go to the resultAdjusted odds ratio 1.7 95% CI 1.2–2.5

Authors' conclusion

In this cohort study, less favorable prepregnancy CVH was associated with subclinical CVD in midlife, but only a small proportion of this association was mediated through GD.

Study context

Population
Black and White women in CARDIA with ≥1 singleton birth, prepregnancy cardiovascular health (CVH) data, CAC data at 15- to 25-year follow-up and no prepregnancy DM
Participants
1,052 participants
Exposure
Low or moderate vs high prepregnancy CV health
Outcome
Incident CAC >0 (CT)
Follow-up
15- to 25-year follow-up
Methodological detailspopulation-based, nested within CARDIA, 4 US centres, causal mediation analysis
  • Population-based
  • Nested within CARDIA
  • 4 US centres
  • Causal mediation analysis

Main finding

Incident CAC

Adjusted odds ratio

1.7

95% CI 1.2–2.5

By group

Low or moderate CVH vs High CVH
adjusted OR 1.7 (95% CI 1.2–2.5)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeLow or moderate CVHHigh CVHAdjusted OR (95% CI)
Gestational diabetes8.8%6.3%1.8 (1.1–3.0)

Proportion of CVH–CAC association mediated by gestational diabetes (GD)

Proportion mediated through GD
6% (95% CI, 0%-22%)
  • Causal mediation analysis

Original publication

Prepregnancy Cardiovascular Health, Gestational Diabetes, and Coronary Artery Calcium. JAMA Cardiol. Published 1 September 2025. doi:10.1001/jamacardio.2025.1887

Summarised from the published abstract; every number is checked against it

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