Continuation of the NuMoM2b Heart Health Study

PROJECT SUMMARY/ABSTRACT Adverse pregnancy outcomes (APOs), including hypertensive disorders of pregnancy, preterm birth, and small for gestational age birth, as well as gestational diabetes, are associated with cardiovascular disease (CVD) risk in mothers. The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (nuMoM2b) collected biospecimens during pregnancy and extensive phenotyping data for 10,038 nulliparous women from 2010–2014. The nuMoM2b Heart Health Study comprises 7,003 nuMoM2b participants who were recontacted at least once after their nuMoM2b birth, 4,508 of whom returned for an in-person CVD risk factor assessment 2–7 years later. This cohort is currently in a second phase of follow-up, with multiple ancillary studies running in parallel, and is uniquely positioned to address questions about the complex interplay of APOs and maternal CVD. In response to challenges maintaining study participation for individuals who have moved away from their study sites or have difficulty attending on-site visits, the cohort recently piloted new home-based and hybrid (mixed location) approaches to study visits, with enthusiastic response from participants. We propose two activities to build on this innovation that will allow us to continue to improve participant retention and expand the network’s scope of data capture: • Continuing to offer remote and hybrid study visits. Since the original nuMoM2b enrollment, more than 30% of study participants have moved away from their network sites and are no longer located within a travel distance that allows them to attend in-person study visits, and many others cannot attend full on-site visits because of family and work commitments or health challenges. Building on the enthusiastic response to our initial offering of remote and hybrid visit approaches, we propose to continue offering these forms of visits as a strategic approach to maintaining engagement of these participants. This task includes providing continued addition support to network sites and the Data Coordinating and Analysis center for operational support for the visits and funding for proteomic analysis of the remotely collected biospecimens. • Expanding data collection to include electronic health records. To further improve the rigor of our understanding of maternal CVD development and address recommendations from our Observational Study Monitoring Board, the network will begin collecting electronic health record data using an innovative participant-driven phone application and site-based data queries.