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The biological processes that lead to adverse pregnancy outcomes begin before pregnancy with higher risk of adverse pregnancy outcomes observed among those with poor prepregnancy CVH. Individuals who experience adverse pregnancy outcomes are also at higher risk of subsequent development of cardiovascular disease, which is largely explained by the interim development of traditional risk factors, such as hypertension and diabetes. Therefore, the peripartum period, which includes the period before (prepregnancy), during, and after pregnancy (postpartum), represents an early cardiovascular moment or window of opportunity when CVH should be measured, monitored, and modified (if needed). However, it remains unclear whether adverse pregnancy outcomes reflect latent risk for cardiovascular disease that is unmasked in pregnancy or if adverse pregnancy outcomes are themselves an independent and causal risk factor for future cardiovascular disease. Understanding the pathophysiologic mechanisms and pathways linking prepregnancy CVH, adverse pregnancy outcomes, and cardiovascular disease are necessary to develop strategies tailored for each stage in the peripartum period. Emerging evidence suggests the utility of subclinical cardiovascular disease screening with biomarkers (eg, natriuretic peptides) or imaging (eg, computed tomography for coronary artery calcium or echocardiography for adverse cardiac remodeling) to identify risk-enriched postpartum populations and target for more intensive strategies with health behavior interventions or pharmacological treatments. However, evidence-based guidelines focused on adults with a history of adverse pregnancy outcomes are needed to prioritize the prevention of cardiovascular disease during the reproductive years and beyond.<\/jats:p>","DOI":"10.1161\/circresaha.123.322001","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T14:00:33Z","timestamp":1686232833000},"page":"1584-1606","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["Pregnancy as an Early Cardiovascular Moment: Peripartum Cardiovascular Health"],"prefix":"10.1161","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0643-1859","authenticated-orcid":true,"given":"Sadiya S.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Medicine (S.S.K., N.A.C.), Northwestern University Feinberg School of Medicine, Chicago, IL."},{"name":"Department of Preventive Medicine (S.S.K.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-7580","authenticated-orcid":true,"given":"Natalie A.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Medicine (S.S.K., N.A.C.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-0006","authenticated-orcid":true,"given":"Kathryn J.","family":"Lindley","sequence":"additional","affiliation":[{"name":"Department of Medicine (K.J.L.), Vanderbilt University Medical Center, Nashville, TN."},{"name":"Department of Obstetrics and Gynecology (K.J.L.), Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6818e1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","unstructured":"Hoyert DL. 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