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Both followed children into adulthood and measured cardiovascular risk factors, including body mass index (BMI), systolic and diastolic blood pressure (SBP\/DBP), total, lipoprotein (LDL)\u2010 and high density lipoprotein (HDL)\u2010cholesterol and serum triglycerides. Discrete mixture modelling was used to divide each cohort into distinct trajectories according to these risk factors from childhood to early adulthood, and these groups were then used to predict pregnancy outcomes including small for gestational age (SGA; &lt;10th study\u2010specific percentile of gestational age by sex), preterm birth (PTB; &lt;37\u2009weeks' gestation), hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with control for age at baseline and at first birth, parity, socioeconomic status, BMI and smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The models created more trajectories for BMI, SBP and HDL\u2010cholesterol in the YFS than in BHS, for which three classes generally seemed to be sufficient to represent the groups in the population across risk factors. In BHS, the association between the higher and flatter DBP trajectory and PTB was aRR 1.77, 95% confidence interval [CI] 1.06, 2.96. In BHS the association between consistent total cholesterol and PTB was aRR 2.16, 95% CI 1.22, 3.85 and in YFS the association between elevated high trajectory and PTB was aRR 3.35, 95% CI 1.28, 8.79. Elevated\u2010increasing SBP was associated with a higher risk of GH in BHS and increasing or persistent\u2010obese BMI trajectories were associated with GDM in both cohorts (BHS: aRR 3.51, 95% CI 1.95, 6.30; YFS: aRR 2.61, 95% CI 0.96, 7.08).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Trajectories of cardiovascular risk, particularly those that represent a consistent or more rapid worsening of cardiovascular health, are associated with a higher risk of pregnancy complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12995","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T14:53:30Z","timestamp":1689087210000},"page":"168-179","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trajectories of cardiovascular risk predict pregnancy outcomes: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns 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