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Adverse pregnancy outcomes are common among pregnant individuals and are associated with long-term risk of cardiovascular disease. Individuals with adverse pregnancy outcomes also have an increased incidence of cardiovascular disease risk factors after delivery. Despite this, evidence-based approaches to managing these patients after pregnancy to reduce cardiovascular disease risk are lacking. In this scientific statement, we review the current evidence on interpregnancy and postpartum preventive strategies, blood pressure management, and lifestyle interventions for optimizing cardiovascular disease using the American Heart Association Life's Essential 8 framework. Clinical, health system, and community-level interventions can be used to engage postpartum individuals and to reach populations who experience the highest burden of adverse pregnancy outcomes and cardiovascular disease. Future trials are needed to improve screening of subclinical cardiovascular disease in individuals with a history of adverse pregnancy outcomes, before the onset of symptomatic disease. Interventions in the fourth trimester, defined as the 12 weeks after delivery, have great potential to improve cardiovascular health across the life course.

There is limited research that specifically explores paternal involvement during pregnancy and childbirth. To address this gap, we completed a series of focus groups with fathers to examine social, cultural, and environmental factors that influence behaviors among new fathers while also providing community perspectives on men's experiences seeking care pre- and postdelivery. We used a phenomenological thematic approach to analyze data from 10 focus groups from five of the six Alliance for Innovation on Maternal Health-Community Care Initiative pilot sites collected between November 2021 and April 2022. The average age of fathers was 33.9 years (range = 24-61 years). The majority (86.25%) of men were African American, and approximately one sixth of focus group participants (16.25%) were Hispanic or Latino. Four key themes emerged: the importance and meaning of fatherhood, accessibility during pregnancy and childbirth, engagement during pregnancy and childbirth, and responsibility of fathers during pregnancy and childbirth. These fathers not only understood and embraced the awesome responsibility they had for their unborn child, but they also recognized and were invested in being present, accessible, engaged, and responsible to the pregnant woman during the pregnancy. Practitioners and policy makers should work to engage fathers as early in the pregnancy as possible; monitor father's mental health and financial stress; provide resources to educate fathers on maternal health, pregnancy, and childbirth; and emphasize fathers' rights, roles, and responsibilities.

Objective To review fetal and infant deaths from women enrolled in Indianapolis Healthy Start using the National Fetal and Infant Mortality Review (FIMR) methods to provide strategies for prevention. Methods: Marion County Public Health Department (MCPHD) FIMR staff identified and reviewed 22 fetal and infant deaths to Indianapolis Healthy Start program participants between 2005 and 2012. Trained FIMR nurses completed 13 of 20 maternal interviews and compiled case summaries of all deaths from the MCPHD FIMR database.. Results Case review teams identified a total of 349 family strengths, 219 contributing factors, and made 220 recommendations for future pregnancies. FIMR deliberation values for Healthy Start program participant deaths were similar to other infant deaths in Marion County during the same time period. Common themes that emerged from the reviews included lack of social support, absence of paternal involvement, substance abuse, non-compliance, and poor health behaviors leading to chronic health conditions that complicated many pregnancies. Conclusions A number of the infant deaths in this review could have been prevented with preconception and inter-conception education and by improving the quality and content of prenatal care., Author(s): Haywood L. Brown [sup.1] [sup.4] , Mark Smith [sup.2] , Yvonne Beasley [sup.2] , Teri Conard [sup.2] , Anne Lise Musselman [sup.2] , Virginia A. Caine [sup.2] [sup.3] Author [...]

This study evaluated the influence of early gestational weight gain (GWG) on neonatal outcomes among women with class III obesity. Retrospective cohort of women with class III obesity who gained more than the Institute of Medicine (IOM) guidelines (>20lbs). Women gaining ≥75% of total gestational weight prior to 28 weeks (EWG) were compared to women gaining <75% of their total weight prior to 28 weeks (SWG). The primary outcome was a neonatal composite morbidity and mortality. Secondary outcomes included individual components of composite and LGA. Of 144 women identified, 42 (29.2%) had EWG and 102 (70.8%) had SWG. Though 11% of the total population had composite neonatal morbidity, this did not differ between groups (p =.4). LGA was nearly twice as common in the SWG group (41% vs 26%, p =.13). EWG was associated with decreased risk of LGA (AOR 0.25 95% CI 0.08, 0.78) and lower median birth weight (AOR −312 g 95% CI −534.7, −90.2). Though adverse neonatal outcomes were common in this population, timing of gestational weight gain was not correlated. Increased rates of LGA and higher median birth weight in the SWG group suggests excessive GWG continuing in the third trimester of pregnancy may be of import for neonatal size. [ABSTRACT FROM AUTHOR]