{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:12:36Z","timestamp":1789269156014,"version":"build-2803163510"},"reference-count":69,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Assessment of cardiovascular health (CVH) during pregnancy may unmask latent metabolic vulnerability and indicate long-term disease risk. However, the prognostic value of the American Heart Association\u2019s Life\u2019s Essential 8 (LE8) framework during pregnancy remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate CVH during pregnancy using a modified LE8 (mLE8) score in association with time to incident cardiometabolic disease.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used electronic medical record (EMR) surveillance for 7 years post partum (August 2018 to March 2026) and included singleton pregnancies in individuals aged 18 to 44 years without preexisting diabetes or cardiovascular disease (CVD) from a large academic medical system in South Carolina. Data were analyzed from December 2024 to April 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n A 7-component mLE8 score assessed during pregnancy, incorporating hypertensive disorders of pregnancy (HDP), 50 g glucose tolerance test results, early pregnancy body mass index, smoking status, sleep adequacy, diet quality, and physical activity. Scores ranged from 0 to 100, with higher scores indicating more favorable CVH.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Postdelivery incident cardiometabolic conditions captured through EMRs and classified as chronic hypertensive conditions, chronic metabolic conditions (eg, dyslipidemia, impaired glucose regulation), and CVD (eg, cardiac arrest, cardiomyopathy). Adjusted accelerated time-to-failure models estimated mLE8 associations with incident conditions. Time to incident diagnosis was measured in days from delivery.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 1225 pregnancies (mean [SD] age, 25.0 [5.3] years), 499 incident cardiometabolic events occurred over a median (IQR) follow-up of 6.2 (2.8) years. Each 10-point higher mLE8 score was associated with a longer time to incident diagnosis of chronic hypertensive conditions (time ratio [TR], 1.26; 95% CI, 1.11-1.42) and chronic metabolic conditions (TR, 1.20; 95% CI, 1.11-1.29). Healthier HDP (1.06 [1.03-1.10]), glucose (1.15 [1.10-1.21]), body mass index (1.07 [1.04-1.11]), and sleep (1.05 [1.00-1.09]) scores were associated with longer time to diagnosis of chronic metabolic conditions. Associations were generally similar after excluding individuals with gestational diabetes or HDP.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of 1225 pregnancies, better CVH during pregnancy was associated with a longer time to incident postdelivery diagnosis of cardiometabolic conditions. Pregnancy-based CVH assessment may help identify individuals with elevated and emerging cardiometabolic risk who could benefit from early, targeted intervention and enhanced longitudinal surveillance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.19910","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:34:18Z","timestamp":1782747258000},"page":"e2619910","source":"Crossref","is-referenced-by-count":1,"title":["Life\u2019s Essential 8 in Pregnancy and Time to Incident Cardiometabolic Disease Over 7 Years Follow-Up"],"prefix":"10.1001","volume":"9","author":[{"given":"Ellen C.","family":"Francis","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalin","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anushka","family":"Pande","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Keenan-Devlin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health; Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Endeavor Health, Evanston, Illinois"},{"name":"Department of Pathology, University of Chicago Pritzker School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey"},{"name":"Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Borders","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health; Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shristi","family":"Rawal","sequence":"additional","affiliation":[{"name":"Department of Clinical and Preventative Nutrition Sciences, School of Health Professions, Rutgers University, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Crockett","sequence":"additional","affiliation":[{"name":"Prisma Health\/University of South Carolina School of Medicine Greenville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"issue":"7","key":"zoi260553r1","doi-asserted-by":"publisher","first-page":"e330","DOI":"10.1161\/CIR.0000000000001212","article-title":"Opportunities in the postpartum period to reduce cardiovascular disease risk after adverse pregnancy outcomes: a scientific statement from the American Heart Association.","volume":"149","author":"Lewey","year":"2024","journal-title":"Circulation"},{"issue":"18","key":"zoi260553r2","doi-asserted-by":"publisher","first-page":"e902","DOI":"10.1161\/CIR.0000000000000961","article-title":"Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association.","volume":"143","author":"Parikh","year":"2021","journal-title":"Circulation"},{"issue":"9","key":"zoi260553r3","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1089\/jwh.2023.0026","article-title":"Adverse pregnancy outcomes and future metabolic syndrome.","volume":"32","author":"Ehrenthal","year":"2023","journal-title":"J Womens Health (Larchmt)"},{"issue":"6","key":"zoi260553r4","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1089\/jwh.2021.0449","article-title":"Excessive gestational weight gain and long-term maternal cardiovascular risk profile: the study of women\u2019s health across the nation.","volume":"31","author":"Hutchins","year":"2022","journal-title":"J Womens Health (Larchmt)"},{"issue":"6","key":"zoi260553r5","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1097\/AOG.0000000000005569","article-title":"Adverse pregnancy outcomes and predicted 30-year risk of maternal cardiovascular disease 2-7 years after delivery.","volume":"143","author":"Venkatesh","year":"2024","journal-title":"Obstet Gynecol"},{"issue":"5","key":"zoi260553r6","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15516","article-title":"Hypertensive disorders of pregnancy and gestational diabetes mellitus and predicted risk of maternal cardiovascular disease 10-14?years after delivery: a prospective cohort.","volume":"42","author":"Venkatesh","year":"2025","journal-title":"Diabet Med"},{"key":"zoi260553r7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070244","article-title":"Association of gestational diabetes mellitus with overall and type specific cardiovascular and cerebrovascular diseases: systematic review and meta-analysis.","volume":"378","author":"Xie","year":"2022","journal-title":"BMJ"},{"issue":"8","key":"zoi260553r8","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1161\/CIRCULATIONAHA.118.036748","article-title":"Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications.","volume":"139","author":"Grandi","year":"2019","journal-title":"Circulation"},{"issue":"11","key":"zoi260553r9","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1001\/jamainternmed.2023.4401","article-title":"Association of gestational diabetes with subsequent long-term risk of mortality.","volume":"183","author":"Wang","year":"2023","journal-title":"JAMA Intern Med"},{"issue":"24","key":"zoi260553r10","doi-asserted-by":"publisher","first-page":"e843","DOI":"10.1161\/CIR.0000000000000582","article-title":"Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory From the American Heart Association and the American College of Obstetricians and Gynecologists.","volume":"137","author":"Brown","year":"2018","journal-title":"Circulation"},{"issue":"4","key":"zoi260553r11","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1097\/AOG.0000000000003762","article-title":"Social determinants of pregnancy-related mortality and morbidity in the United States: a systematic review.","volume":"135","author":"Wang","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"4","key":"zoi260553r12","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1136\/heartjnl-2018-313439","article-title":"Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy.","volume":"105","author":"Dam","year":"2019","journal-title":"Heart"},{"issue":"12","key":"zoi260553r13","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1177\/2047487319879791","article-title":"Risk prediction of maternal cardiovascular disease one year after hypertensive pregnancy complications or gestational diabetes mellitus.","volume":"27","author":"Moe","year":"2020","journal-title":"Eur J Prev Cardiol"},{"issue":"3","key":"zoi260553r14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.124.011217","article-title":"Determinants of racial and ethnic differences in maternal cardiovascular health in early pregnancy.","volume":"18","author":"Cameron","year":"2025","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"9","key":"zoi260553r15","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1001\/jamainternmed.2018.2875","article-title":"Evaluation of the pooled cohort risk equations for cardiovascular risk prediction in a multiethnic cohort from the women\u2019s health initiative.","volume":"178","author":"Mora","year":"2018","journal-title":"JAMA Intern Med"},{"issue":"19","key":"zoi260553r16","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1161\/CIR.0000000000001139","article-title":"Cardiovascular disease risk factors in women: the impact of race and ethnicity: a scientific statement from the American Heart Association.","volume":"147","author":"Mehta","year":"2023","journal-title":"Circulation"},{"issue":"14","key":"zoi260553r17","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011874","article-title":"Atherosclerotic cardiovascular disease risk prediction in disaggregated Asian and Hispanic subgroups using electronic health records.","volume":"8","author":"Rodriguez","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"zoi260553r18","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1161\/CIRCULATIONAHA.123.067626","article-title":"Development and validation of the American Heart Association\u2019s PREVENT equations.","volume":"149","author":"Khan","year":"2024","journal-title":"Circulation"},{"issue":"14","key":"zoi260553r19","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1093\/eurheartj\/ehy863","article-title":"Does pregnancy complication history improve cardiovascular disease risk prediction: findings from the HUNT study in Norway.","volume":"40","author":"Markovitz","year":"2019","journal-title":"Eur Heart J"},{"issue":"2","key":"zoi260553r20","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022349","article-title":"Does Adding adverse pregnancy outcomes improve the Framingham Cardiovascular risk score in women? data from the Tehran lipid and glucose study.","volume":"11","author":"Saei Ghare Naz","year":"2022","journal-title":"J Am Heart Assoc"},{"issue":"9","key":"zoi260553r21","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1001\/jamapediatrics.2014.472","article-title":"Effect of home visiting by nurses on maternal and child mortality: results of a 2-decade follow-up of a randomized clinical trial.","volume":"168","author":"Olds","year":"2014","journal-title":"JAMA Pediatr"},{"issue":"5","key":"zoi260553r22","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/CIR.0000000000001078","article-title":"Life\u2019s Essential 8: Updating and Enhancing the American Heart Association\u2019s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association.","volume":"146","author":"Lloyd-Jones","year":"2022","journal-title":"Circulation"},{"issue":"10448","key":"zoi260553r23","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/S0140-6736(24)00825-0","article-title":"Epidemiology and management of gestational diabetes.","volume":"404","author":"Sweeting","year":"2024","journal-title":"Lancet"},{"issue":"1","key":"zoi260553r24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/AOG.0000000000004824","article-title":"Trends in hypertensive disorders of pregnancy in the United States From 1989 to 2020.","volume":"140","author":"Bruno","year":"2022","journal-title":"Obstet Gynecol"},{"issue":"4","key":"zoi260553r25","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.015123","article-title":"Cardiovascular health among pregnant women, aged 20 to 44 years, in the United States.","volume":"9","author":"Perak","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"7","key":"zoi260553r26","doi-asserted-by":"publisher","first-page":"e76","DOI":"10.1161\/CIR.0000000000001124","article-title":"Optimizing prepregnancy cardiovascular health to improve outcomes in pregnant and postpartum individuals and offspring: a scientific statement from the American Heart Association.","volume":"147","author":"Khan","year":"2023","journal-title":"Circulation"},{"issue":"1","key":"zoi260553r27","doi-asserted-by":"publisher","first-page":"15355","DOI":"10.1038\/s41598-024-66029-6","article-title":"Longitudinal association between maternal cardiovascular health in pregnancy and child birth outcomes.","volume":"14","author":"Jing","year":"2024","journal-title":"Sci Rep"},{"issue":"10","key":"zoi260553r28","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1093\/eurjpc\/zwaf021","article-title":"Life\u2019s essential 8 and cardiovascular disease in women with a history of adverse pregnancy outcomes.","volume":"32","author":"Chen","year":"2025","journal-title":"Eur J Prev Cardiol"},{"issue":"2","key":"zoi260553r29","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2217\/17455057.5.2.101","article-title":"Reproductive health as a sentinel of chronic disease in women.","volume":"5","author":"Rich-Edwards","year":"2009","journal-title":"Womens Health (Lond)"},{"issue":"1","key":"zoi260553r30","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s12884-017-1295-7","article-title":"Centering and Racial Disparities (CRADLE study): rationale and design of a randomized controlled trial of centeringpregnancy and birth outcomes.","volume":"17","author":"Chen","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"zoi260553r31","doi-asserted-by":"publisher","first-page":"893.e1","DOI":"10.1016\/j.ajog.2022.06.066","article-title":"Group vs traditional prenatal care for improving racial equity in preterm birth and low birthweight: the Centering and Racial Disparities randomized clinical trial study.","volume":"227","author":"Crockett","year":"2022","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"zoi260553r32","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/CIR.0000000000001078","article-title":"Life\u2019s Essential 8: updating and enhancing the American Heart Association\u2019s construct of cardiovascular health: a presidential advisory from the American Heart Association.","volume":"146","author":"Lloyd-Jones","year":"2022","journal-title":"Circulation"},{"issue":"8","key":"zoi260553r34","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity.","volume":"35","author":"Craig","year":"2003","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"zoi260553r35","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1097\/00006199-199009000-00003","article-title":"A Spanish language version of the health-promoting lifestyle profile.","volume":"39","author":"Walker","year":"1990","journal-title":"Nurs Res"},{"issue":"2","key":"zoi260553r36","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1097\/00006199-198703000-00002","article-title":"The health-promoting lifestyle profile: development and psychometric characteristics.","volume":"36","author":"Walker","year":"1987","journal-title":"Nurs Res"},{"issue":"2","key":"zoi260553r37","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1097\/AOG.0000000000002501","article-title":"ACOG Practice bulletin no. 190: gestational diabetes mellitus.","volume":"131","author":"ACOG Committee on Obstetric Practice","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"6","key":"zoi260553r38","doi-asserted-by":"publisher","first-page":"e237","DOI":"10.1097\/AOG.0000000000003891","article-title":"Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222.","volume":"135","author":"ACOG Committee on Obstetric Practice","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"7","key":"zoi260553r39","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1161\/CIRCULATIONAHA.121.057107","article-title":"Geographic differences in prepregnancy cardiometabolic health in the United States, 2016 through 2019.","volume":"145","author":"Cameron","year":"2022","journal-title":"Circulation"},{"issue":"1","key":"zoi260553r40","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1161\/CIRCGENETICS.114.000216","article-title":"Quantitative serum nuclear magnetic resonance metabolomics in cardiovascular epidemiology and genetics.","volume":"8","author":"Soininen","year":"2015","journal-title":"Circ Cardiovasc Genet"},{"issue":"25","key":"zoi260553r41","doi-asserted-by":"publisher","first-page":"2850","DOI":"10.1016\/j.jacc.2016.09.972","article-title":"The emerging role of metabolomics in the diagnosis and prognosis of cardiovascular disease.","volume":"68","author":"Ussher","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"zoi260553r42","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1097\/MLR.0000000000000735","article-title":"Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.","volume":"55","author":"Moore","year":"2017","journal-title":"Med Care"},{"issue":"1","key":"zoi260553r43","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1093\/aje\/kwab208","article-title":"Adverse cardiovascular events following severe maternal morbidity.","volume":"191","author":"Cartus","year":"2022","journal-title":"Am J Epidemiol"},{"issue":"7","key":"zoi260553r45","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1001\/jama.2021.13304","article-title":"Committee AMOS: updated guidance on the reporting of race and ethnicity in medical and science journals.","volume":"326","author":"Flanagin","year":"2021","journal-title":"JAMA"},{"issue":"23","key":"zoi260553r46","doi-asserted-by":"publisher","first-page":"e1059","DOI":"10.1161\/CIR.0000000000001071","article-title":"Call to action for cardiovascular disease in women: epidemiology, awareness, access, and delivery of equitable health care: a presidential advisory from the American Heart Association.","volume":"145","author":"Wenger","year":"2022","journal-title":"Circulation"},{"issue":"4","key":"zoi260553r47","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/ppe.12474","article-title":"Revisiting the table 2 fallacy: a motivating example examining preeclampsia and preterm birth.","volume":"32","author":"Bandoli","year":"2018","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"3","key":"zoi260553r48","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1161\/HYPERTENSIONAHA.111.00143","article-title":"Preterm birth and future maternal blood pressure, inflammation, and intimal-medial thickness: the CARDIA study.","volume":"61","author":"Catov","year":"2013","journal-title":"Hypertension"},{"issue":"2","key":"zoi260553r49","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000490","article-title":"History of gestational diabetes mellitus and future risk of atherosclerosis in mid-life: the coronary artery risk development in young adults study.","volume":"3","author":"Gunderson","year":"2014","journal-title":"J Am Heart Assoc"},{"issue":"10","key":"zoi260553r50","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1161\/CIRCULATIONAHA.120.047320","article-title":"Gestational diabetes history and glucose tolerance after pregnancy associated with coronary artery calcium in women during midlife: The CARDIA Study.","volume":"143","author":"Gunderson","year":"2021","journal-title":"Circulation"},{"issue":"15","key":"zoi260553r51","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011394","article-title":"Early pregnancy cardiovascular health and subclinical atherosclerosis.","volume":"8","author":"Benschop","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"10","key":"zoi260553r52","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1161\/HYPERTENSIONAHA.124.24517","article-title":"Lower prepregnancy cardiovascular health is associated with hypertensive disorders of pregnancy: the CARDIA study.","volume":"82","author":"Dodds","year":"2025","journal-title":"Hypertension"},{"issue":"9","key":"zoi260553r53","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1001\/jamacardio.2025.1887","article-title":"Prepregnancy Cardiovascular health, gestational diabetes, and coronary artery calcium.","volume":"10","author":"Cameron","year":"2025","journal-title":"JAMA Cardiol"},{"issue":"9","key":"zoi260553r54","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.005947","article-title":"Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies.","volume":"6","author":"Yin","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"zoi260553r55","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101436","article-title":"Sleep disturbances during pregnancy and adverse maternal and fetal outcomes: a systematic review and meta-analysis.","volume":"58","author":"Lu","year":"2021","journal-title":"Sleep Med Rev"},{"issue":"13","key":"zoi260553r56","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1161\/CIRCULATIONAHA.122.062177","article-title":"Pregnancy complications and long-term mortality in a diverse cohort.","volume":"147","author":"Hinkle","year":"2023","journal-title":"Circulation"},{"issue":"15","key":"zoi260553r57","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038566","article-title":"Cardiovascular health, 2010 to 2020: a systematic review of a decade of research on life\u2019s simple 7.","volume":"14","author":"Aguayo","year":"2025","journal-title":"J Am Heart Assoc"},{"issue":"1-2","key":"zoi260553r58","first-page":"3","article-title":"Patient perspectives of obstetrician-gynecologists as primary care providers.","volume":"62","author":"Mazzoni","year":"2017","journal-title":"J Rep Med"},{"issue":"1","key":"zoi260553r59","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1300\/J013v37n01_02","article-title":"Assessing primary care performance in an obstetrics\/gynecology clinic.","volume":"37","author":"Scholle","year":"2003","journal-title":"Women Health"},{"issue":"12","key":"zoi260553r61","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1161\/CIRCRESAHA.123.322001","article-title":"Pregnancy as an early cardiovascular moment: peripartum cardiovascular health.","volume":"132","author":"Khan","year":"2023","journal-title":"Circ Res"},{"issue":"8","key":"zoi260553r62","doi-asserted-by":"publisher","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart disease and stroke statistics update: a report from the American Heart Association.","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"key":"zoi260553r63","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpc.2024.100925","article-title":"Association of neighborhood-level socioeconomic disadvantage and life\u2019s essential 8 in early pregnancy.","volume":"21","author":"Venkatesh","year":"2025","journal-title":"Am J Prev Cardiol"},{"issue":"2","key":"zoi260553r64","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2337\/diacare.26.2.265","article-title":"Did publication of a clinical practice guideline recommendation to screen for type 2 diabetes in women with gestational diabetes change practice","volume":"26","author":"Clark","year":"2003","journal-title":"Diabetes Care"},{"issue":"9","key":"zoi260553r65","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1089\/jwh.2013.4688","article-title":"Postpartum healthcare after gestational diabetes and hypertension.","volume":"23","author":"Ehrenthal","year":"2014","journal-title":"J Womens Health (Larchmt)"},{"issue":"10","key":"zoi260553r66","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.3856","article-title":"Trends in racial and ethnic disparities in barriers to timely medical care among adults in the US, 1999 to 2018.","volume":"3","author":"Caraballo","year":"2022","journal-title":"JAMA Health Forum"},{"issue":"10","key":"zoi260553r67","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1080\/14622200701491255","article-title":"Misclassification of maternal smoking status and its effects on an epidemiologic study of pregnancy outcomes.","volume":"9","author":"England","year":"2007","journal-title":"Nicotine Tob Res"},{"issue":"13","key":"zoi260553r69","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1111\/1471-0528.15394","article-title":"Recurrence of pre-eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta-analysis.","volume":"125","author":"Brouwers","year":"2018","journal-title":"BJOG"},{"key":"zoi260553r44","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4419-6646-9","volume-title":"Survival Analysis: A Self-Learning Text","author":"Kleinbaum","year":"2012"},{"key":"zoi260553r68","volume-title":"Statistical Methods in Cancer Research Volume V: Bias Assessment in Case\u2013Control and Cohort Studies for Hazard Identification","author":"Stayner","year":"2024"},{"key":"zoi260553r33","unstructured":"Food and Nutrition Service. Women, Infants, and Children (WIC): United States Department of Agriculture. United States Department of Agriculture. Accessed May 13, 2026. https:\/\/www.fns.usda.gov\/wic\/women-infants-and-children-wic"},{"key":"zoi260553r60","unstructured":"Arendt? K, Clare? C, Damp? J, . Patient safety bundles [online resource]. Alliance for Innovation on Maternal Health. Accessed May 13, 2026. https:\/\/saferbirth.org\/psbs\/cardiac-conditions-in-obstetric-care\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2850950\/francis_2026_oi_260553_1782852614.22838.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T21:29:28Z","timestamp":1782854968000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2850950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":69,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.19910","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]}}}