Pregnancy offers a unique window into a woman’s future heart and cardiovascular health. Conditions such as hypertensive disorders of pregnancy (HDP) which include gestational hypertension, preeclampsia (with or without severe features), and eclampsia, not only affect pregnancy outcomes but also signal higher long-term risk for heart disease. Identifying people at higher risk early in pregnancy could allow for closer monitoring and earlier lifestyle support.

In a recent study, researchers explored whether the American Heart Association’s Life’s Essential 8 (LE8) framework could help identify pregnant individuals at increased risk for HDP. Life’s Essential 8 outlines key, modifiable factors that support heart health: diet, physical activity, nicotine exposure, sleep health, body mass index (BMI), blood pressure, blood lipids, and blood glucose. The study analyzed data from 6,304 first-time pregnant participants enrolled between 6 and 14 weeks of gestation in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a large, multicenter U.S. cohort conducted from 2010 to 2013.

Using early pregnancy data—including measured blood pressure and BMI, along with self-reported diet, sleep (including snoring), physical activity, and nicotine exposure—researchers grouped participants into four cardiovascular health profiles:

1. Healthy behaviors / Normal BMI and blood pressure (42%)
2. No physical activity / Normal BMI and blood pressure (31%)
3. High snoring / Elevated BMI (18%)
4. Poor behaviors / Normal BMI and blood pressure (8%)

When outcomes were examined later in pregnancy, two profiles stood out as higher risk. Participants in the High snoring / Elevated BMI group had 2.4 times the risk of developing an HDP, while those in the Poor behaviors / Normal BMI and blood pressure group had a 1.5 times higher risk, compared with the healthy behavior group. The “poor behaviors” profile included factors such as nicotine use or exposure, low physical activity, and poor diet quality—even when blood pressure and BMI were still within normal ranges early in pregnancy.

Overall, the findings suggest that a combination of lifestyle behaviors, rather than any single factor, may better identify people at risk for developing high blood pressure conditions during pregnancy. The authors note that screening for symptoms such as habitual snoring, often linked to sleep-disordered breathing, could be a simple way to flag higher-risk patients earlier.

Take Home Message: Using the American Heart Association’s Life’s Essential 8 framework, researchers found that certain early-pregnancy cardiovascular health profiles, particularly those involving higher body weight, snoring, low physical activity, nicotine exposure, and poor diet, were linked to a higher risk of hypertensive disorders of pregnancy. While no pregnancy-specific version of Life’s Essential 8 currently exists, this study highlights an opportunity to adapt heart-health frameworks for pregnancy and to support early, practical lifestyle interventions that may improve outcomes for both parent and baby.

Citation: https://doi.org/10.1016/j.preghy.2025.101260

About Research Roundup:

Each quarter, our team of science writers reviews the most current research studies related to hypertensive disorders of pregnancy and summarizes those studies of greatest interest and potential impact to our community, including research studies related to risk assessment, diagnosis, prevention, and treatment. Special thanks to our volunteer research team including Dr. Sig-Linda Jacobson, Dr. Jennifer Mitchell, Dr. Julie Reynolds, Amanda Yang, and Simren Gupta who make Research Roundup possible, and to our Patient Advisory Council, who reviews these materials from the patient perspective.