Continuation of the nuMoM2b Heart Health Study

Study Overview
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Brief Summary
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Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in U.S. women at all ages, and large knowledge gaps exist in CVD predictive and preventative strategies for women. The nuMoM2b Heart Health Study (nuMoM2b-HHS) has followed a demographically diverse cohort of women enrolled and richly phenotyped during their first pregnancy, with data and biospecimens prospectively collected for up to 7 years thereafter. The overarching scientific goal of this study is to define the relationship between adverse pregnancy outcomes (APOs) and CVD to optimize CVD prediction, prevention, and treatment strategies for women. Continued follow-up of this observational cohort, building on a foundation of existing high-quality data, biospecimens, and administrative structures with a robust framework for ancillary study development and implementation, provides a unique opportunity to address knowledge gaps regarding the early mechanisms and trajectory of CVD in women.

Detailed Description
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The Continuation of nuMoM2b Heart Health Study (nuMoM2b-HHS2) will include prospectively collected longitudinal data on CVD risk factors and early clinical manifestations of CVD, the study's primary outcomes of interest. Measures completed during semiannual follow-ups will include 1) self-reported interval medical history, including medications and substance use; 2) interval pregnancy and postpartum history; 3) interval CVD events, conditions, and diagnostic and therapeutic procedures including CVD death, myocardial infarction (MI), stroke, transient ischemic attack (TIA), pulmonary embolism (PE), deep vein thrombosis (DVT), peripheral vascular disease, kidney disease, hypertension, diabetes, hyperlipidemia, and associated hospitalizations and procedures. During an in-person visit in years 3-5, the participant's blood pressure, pulse rate, weight, height, and body measurements will be recorded. During the visit, a fasting blood draw and clean-catch urine specimen will be collected. Aliquots of whole blood, plasma, serum, and urine will be stored at the biorepository; these will be analyzed for CVD measures of lipids, triglycerides, and glucose, among others. Measures of behavioral risk factors, including nutrition, physical activity, and stress will also be completed. Ancillary studies will expand data collection during the follow-up contacts and in-person visit, and add to the planned contact schedule, to permit the effective targeting of knowledge gaps required to optimize predictive and preventative strategies. Some ancillary studies will only rely on extant data, while others will require de novo data collection during the planned follow-up contacts and/or in-person visits (or participation in additional in-person visits).

Official Title
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Continuation of the nuMoM2b Heart Health Study

Conditions
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Cardiovascular Diseases

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for nuMoM2b-HHS2 interval contact (telephone interview or web-based self-administered survey): Completed one or more interval contacts during the nuMoM2b Heart Health Study. Able to speak or read in English or Spanish. Exclusion Criteria for nuMoM2b-HHS2 interval contact (telephone interview or web-based self-administered survey): Withdrawal from study. Inclusion Criteria for nuMoM2b-HHS2 in-person visit: Completed one or more interval contacts during the nuMoM2b Heart Health Study. Self-report of at least 3 months postpartum from any subsequent pregnancy. Provision of signed informed consent for the HHS2 in-person research visit. Able to speak or read English or Spanish. Exclusion Criteria for nuMoM2b-HHS2 in-person visit: Current pregnancy. Withdrawal from study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| nuMoM2b Heart Health Study Cohort<br>A large and diverse (both geographically and demographically) group of adult women enrolled and richly phenotyped during their first pregnancy, with data and biospecimens prospective collected thereafter. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of hypertension (130/80 mmHg) | Measured blood pressure > 130/80 mmHg, use of antihypertensive medication, or self-report of a hypertension clinical diagnosis | Assessed during the HHS2 in-person visit, 8-16 years after the index pregnancy. | 
| Incidence of diabetes | Measured hemoglobin A1c GE 6.5%, fasting blood glucose GE 126 mg/dL, use of blood sugar lowering medication, or self-report of a diabetes clinical diagnosis | Assessed during the HHS2 in-person visit, 8-16 years after the index pregnancy. | 
| Incidence of obesity | Measured BMI GE 30 kg/m^2 | Assessed during the HHS2 in-person visit, 8-16 years after the index pregnancy. | 
| Incidence of metabolic syndrome | Per the American Heart Association standard definition: Any three of the following five - 1) waist circumference > 35 inches (88 cm) for non-Asians and > 31.5 inches (80 cm) for Asians; 2) triglycerides > 150 mg/dL or medication treatment for high triglycerides; 3) high density lipoprotein (HDL) < 50 mg/dL or medication treatment for low HDL; 4) a serum glucose ≥ 100 mg/dL or a diagnosis of diabetes mellitus; 5) systolic blood pressure (SBP) ≥ 130 mmHg or diastolic blood pressure (DBP) ≥ 85 mmHg, or medication treatment for hypertension. | Assessed during the HHS2 in-person visit, 8-16 years after the index pregnancy. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiovascular Diseases, Adverse Pregnancy Outcomes, Stillbirth, Small for Gestational Age, Preterm Birth, Hypertensive Diseases of Pregnancy, Gestational Diabetes