# Synergistic effects of cardiovascular health and social isolation on adverse pregnancy outcomes

## TL;DR

This study finds that poor cardiovascular health and social isolation during pregnancy increase the risk of adverse outcomes like preeclampsia and preterm birth.

## Contribution

The study reveals a synergistic effect between low cardiovascular health and social isolation in increasing adverse pregnancy outcomes.

## Key findings

- Low cardiovascular health during pregnancy is strongly associated with higher risk of adverse outcomes.
- Socially isolated pregnant women with low cardiovascular health face even higher risk of adverse outcomes.
- High cardiovascular health reduces the negative impact of social isolation on pregnancy outcomes.

## Abstract

Adverse pregnancy outcomes (APOs) affect approximately 20% pregnant women, and their incidence is increasing. The aim of this study was to investigate the effect of cardiovascular health (CVH) during pregnancy on APOs. We analyzed data from 14,930 pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. CVH status during pregnancy was assessed using the eight components of Life’s Essential 8. APOs were defined as composite outcomes encompassing preeclampsia, gestational diabetes mellitus, preterm birth, and small for gestational age. The numbers of participants with high, moderate, and low CVH status were 2891 (19.4%), 11,498 (77.0%), and 541 (3.6%), respectively. Poisson regression analyses with robust error variance, which adjusted for maternal age at conception, alcohol consumption, conception via in vitro fertilization, parity, psychological distress, social isolation, and household income, showed a positive association between moderate and low CVH levels and APOs (risk ratio and 95% confidence interval 1.15 [1.03–1.28] and 2.14 [1.78–2.58], respectively). Among pregnant women with low CVH, those who reported social isolation had a higher prevalence of APOs than did those without social isolation (36.4% vs. 27.4%). This difference was attenuated for pregnant women with high CVH status (13.6% vs. 13.1%). In conclusion, CVH status may be useful for assessing the risk of APOs. Socially isolated pregnant women are more vulnerable to the effects of low CVH status.

The online version contains supplementary material available at 10.1038/s41598-025-03652-x.