# Shared Antecedents to Pre-term Birth and Cardiovascular Disease in Women

> **NIH NIH R21** · MAGEE-WOMEN'S RES INST AND FOUNDATION · 2020 · $120,083

## Abstract

PROJECT ABSTRACT
Cardiovascular disease (CVD) is the leading cause of death among women and rates are rising in young
women. Thus, prevention and early screening are essential. Women with preterm births (PTB) have excess
CVD risk later in life compared to those with term births. It is unclear, however, if PTB unmasks, instigates or
exacerbates a common predisposition. Mechanisms are not understood and pre-pregnancy measures are
almost nonexistent. A few studies, including our own, raise the possibility that preterm birth may have lasting
cardiometabolic effects that increase CVD risk, but longitudinal biomarker data have been unavailable to
directly address this essential question. Inflammation and endothelial function are plausible but under-studied
mechanisms linking PTB and CVD in women. The Coronary Artery Risk Development in Young Adults
(CARDIA) study uniquely includes multiple assessments in women of reproductive age, both before and after
pregnancies. Now in its third decade of follow-up with remarkably strong retention (72%), CARDIA will have
conducted up to 9 in-person exams among 1,362 women (50% Black) who delivered 2,389 births from
baseline to year 30. Uniquely, and just recently available, inflammatory and endothelial function markers have
been measured in 900 CARDIA women from samples obtained both before and after pregnancies. We
hypothesize that preterm birth is related to the pre-pregnancy profile, and additionally leaves a lasting
pro-inflammatory signature that predisposes affected women to endothelial dysfunction,
atherosclerosis and left ventricular remodeling. Our study aims are to 1) relate pre-pregnancy
concentrations of high sensitivity C-reactive protein (hsCRP), soluble intercellular adhesion molecule-1 (s-
ICAM) and tumor necrosis factor-α (TNF-α) to risk of PTB and determine if the change in these markers after
delivery differs according to a history of PTB; and 2) evaluate the association of PTB and these profiles with
atherosclerosis and cardiac remodeling in midlife. These novel studies will fill a major gap in our understanding
of the link between PTB in susceptible women and the potential mechanisms underlying their increased risk of
later CVD. These critical data will be the foundation for the discovery of novel mechanisms linking PTB to later
CVD in women. The impact of this study is that it will be the first to use pre-pregnancy biomarkers of
inflammation and endothelial function to understand the shared link between preterm birth and increased
maternal risk of CVD later in life. These critical data will identify underlying inflammatory and endothelial
mechanisms predisposing to both preterm birth and CVD in women, and pinpoint the timing and types of
interventions needed to improve cardiovascular health in women.

## Key facts

- **NIH application ID:** 9903432
- **Project number:** 5R21HL145419-02
- **Recipient organization:** MAGEE-WOMEN'S RES INST AND FOUNDATION
- **Principal Investigator:** Janet M Catov
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $120,083
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9903432

## Citation

> US National Institutes of Health, RePORTER application 9903432, Shared Antecedents to Pre-term Birth and Cardiovascular Disease in Women (5R21HL145419-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9903432. Licensed CC0.

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