Prevention & lipidsCohort study
Prepregnancy Cardiovascular Health, Gestational Diabetes, and Coronary Artery Calcium
- Prospective cohort study
- population-based
- nested within CARDIA
- 4 US centres
- causal mediation analysis
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
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
| Outcome | Low or moderate CVH | High CVH | adjusted OR (95% CI) | |
|---|---|---|---|---|
| Gestational diabetes | 8.8% | 6.3% | 1.8 (1.1–3.0) | |
| 0.20.5125Adjusted odds ratio (log scale) |
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