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Updated: Jun 23, 2026
Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus
Published on: December 5, 2015
Association between maternal cardiovascular health assessed by modified Life's Essential 8 and risks of adverse
Shen Gao1, Shaofei Su1, Enjie Zhang1
1Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China.
Insights
The American Heart Association's updated cardiovascular health metric, Life's Essential 8 (LE8), is linked to fewer adverse pregnancy outcomes. Higher LE8 scores in early pregnancy correlate with reduced risks for conditions like gestational diabetes and hypertensive disorders.
Area of Science:
- Cardiovascular Health
- Obstetrics
- Public Health
Background:
- The American Heart Association (AHA) updated cardiovascular health (CVH) metrics from Life's Simple 7 (LS7) to Life's Essential 8 (LE8).
- The association between gestational LE8 CVH status and adverse pregnancy outcomes remains unclear.
Purpose of the Study:
- To investigate the association between gestational cardiovascular health, defined by the modified Life's Essential 8 (mLE8) score, and adverse pregnancy outcomes.
- To compare the predictive performance of mLE8 with the previous LS7 metric for adverse pregnancy outcomes.
Main Methods:
- Recruited pregnant women from a China birth cohort study during early gestation (6-13+6 weeks).
- Calculated baseline gestational mLE8 and LS7 CVH scores based on body mass index, nicotine exposure, physical activity, diet, blood pressure, blood glucose, and lipid levels.
- Employed multivariable adjusted logistic regression and receiver operating characteristic (ROC) curves to analyze associations.
Main Results:
- Among 5168 women, each 10-point increase in gestational mLE8 CVH score was significantly associated with decreased risks of pregnancy loss, hypertensive disorders, gestational diabetes mellitus (GDM), preterm birth, large-for-gestational age (LGA), and cesarean delivery.
- The modified LE8 (mLE8) demonstrated a slightly superior ability to predict pregnancy loss, GDM, LGA, and cesarean delivery compared to LS7, as indicated by higher areas under the ROC curves (AUC).
Conclusions:
- Higher gestational mLE8 CVH scores in the first trimester are significantly associated with a lower risk of adverse pregnancy outcomes.
- The mLE8 metric shows potential as a tool for predicting adverse pregnancy outcomes, offering a modest improvement over the LS7 metric.
Background:
The American Heart Association (AHA) has updated the definition of cardiovascular health (CVH) from "Life's Simple 7" (LS7) to "Life's Essential 8" (LE8). The association between gestational LE8 CVH status and adverse pregnancy outcomes is unclear.
Methods:
We recruited pregnant women from the China birth cohort study during 6-13+6 gestation weeks and followed them up until delivery to identify pregnancy outcomes. According to the modified AHA definitions, baseline gestational modified LE8 (mLE8) and LS7 CVH scores were calculated based on body mass index, nicotine exposure, physical activity, diet, blood pressure, blood glucose, and lipid levels. Multivariable adjusted logistic regression and receiver operating characteristic (ROC) curves were used to investigate the association between gestational CVH and adverse pregnancy outcomes.
Results:
Among the 5168 pregnant women finally included, the overall gestational mLE8 CVH score was 81.4 ± 9.6 points. After multivariate adjustment, each 10-points increase in the total overall gestational mLE8 CVH score was significantly associated with a decreased risk of pregnancy loss [odds ratio (OR) = 0.85, 95% CI: 0.76-0.95), hypertensive disorders of pregnancy (OR = 0.50, 95% CI: 0.44-0.58), gestational diabetes mellitus (GDM) (OR = 0.62, 95% CI: 0.57-0.67), preterm birth (OR = 0.76, 95% CI: 0.67-0.86), large-for-gestational age (LGA) (OR = 0.81, 95% CI: 0.73-0.90), and cesarean delivery (OR = 0.77, 95% CI: 0.72-0.82)]. The areas under the ROC curves (AUC) of mLE8 were higher than those of LS7 for pregnancy loss (0.553 vs. 0.537, p = 0.031), GDM (0.626 vs. 0.615, p = 0.023), LGA (0.575 vs. 0.557, p = 0.016), and cesarean delivery (0.574 vs. 0.564, p = 0.005).
Conclusions:
Higher gestational mLE8 CVH scores in the first trimester are significantly associated with a lower risk of adverse pregnancy outcomes. Although the capacity to predict adverse pregnancy outcomes was modest, mLE8 slightly outperformed LS7 in predicting PE, GDM, LGA, and cesarean delivery.
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