Adverse pregnancy outcomes are associated with long-term risk for cardiometabolic disease in both women and their offspring.

Individual cardiovascular risk factors (e.g. obesity and hypertension) present before pregnancy have been associated with higher risk for maternal and neonatal morbidity and mortality; however, the presence of multiple co-occurring risk factors may be associated with greater risk for adverse pregnancy outcomes than any single risk factor alone.

Given the rising prevalence of cardiovascular risk factors in women of reproductive age, identifying the association between the total burden of pre-pregnancy cardiovascular risk factors and adverse maternal and offspring outcomes can help inform comprehensive prevention strategies that move beyond targeting any single risk factor.