Risk Factors for Cardiovascular Disease among Pregnant Women in San Juan, Puerto Rico

Abstract

Objective: Cardiovascular disease (CVD) is the leading cause of death among women in Puerto Rico (PR). Cardiovascular disease risk factors (CVDRF) during pregnancy, such as obesity, type 2 diabetes (T2D), hypertension, and hypertensive disorders of pregnancy, increase risks for maternal and neonatal health. Limited data exist on CVDRF prevalence among pregnant women in PR. Methods: This cross-sectional study analyzed medical records of 264 pregnant women aged 21-35 years with no prior pregnancies from an outpatient clinic in San Juan, PR, during 2018-2019. Key CVDRFs included pre-pregnancy obesity, T2D, gestational diabetes, hypertension, and hypertensive disorders of pregnancy. Age groups (21-25, 26-30, 31-35 years) were assessed for CVDRF prevalence. Logistic and multinomial regressions adjusted for sociodemographic variables were used to evaluate associations. Results: Pre-pregnancy obesity was the most prevalent CVDRF (23.5%). Women aged 31-35 years had significantly higher odds of T2D/ gestational diabetes (OR=4.66; 95% CI=1.18, 18.4) and were more likely to experience two or more CVDRFs (RRR=2.73; 95% CI=1.10, 6.80). Discussion: Findings align with global data showing increased CVDRF prevalence with age among pregnant women. Comparisons with Latino and non-Latino populations reveal shared risks, such as higher rates of gestational diabetes and obesity in older age groups, emphasizing the universal relevance of addressing maternal CVDRFs. Significance: This study highlights the importance of identifying and managing CVDRF among pregnant women in PR, particularly those aged 31-35 years. The findings provide critical data to inform targeted interventions, optimize prenatal care, and reduce long-term maternal and neonatal complications, contributing to improved health outcomes for Puerto Rican women.