(379) Differences in Cardiovascular Disease Symptoms per Trimester Among Risk Screen Positive Pregnant Patients

Cardiovascular disease (CVD) continues to be a leading cause of maternal morbidity and mortality in the United States. The optimal time for CVD risk screening during pregnancy remains uncertain due to symptom and vital sign variability at different gestational ages. This study sought to investigate the symptomatology of CVD in pregnant women who screened positive for CVD risk, with a focus on whether symptom presentation varied across trimesters. Furthermore, we explored the timing of screening on the likelihood of identifying true positive CVD cases.

Study Design: This prospective cohort study included obstetrical patients who screened positive for CVD risk over a year starting June 15, 2022, at an inner-city academic medical center. Universal CVD risk screening was performed during prenatal and postpartum visits using the California Maternal Quality Care Collaborative toolkit. All positive cases underwent ECHO, EKG, and cardio-obstetric team assessment.

Results: Significant differences were observed in the presentation of CVD symptoms among the study cohorts. Shortness of breath was more prevalent in the 2^nd trimester, while hypertension was more common in the 1^st trimester and postpartum period. Interestingly, no significant differences were found in the number of true positive cases identified across the trimesters.

Conclusion:

Our findings highlight the potential influence of pregnancy progression on the manifestation of CVD symptoms, suggesting that the timing of screening could potentially impact disease detection. However, the consistent number of true positive cases identified across all trimesters supports the argument that screening should be conducted regardless of gestational age. This finding underscores the importance of universal screening throughout pregnancy and post-partum. Additionally, the significant increase in hypertension during the 1^st trimester among this perinatal cohort of CVD risk positive patients suggests that underlying pre-existing conditions contribute to CVD, necessitating early management and treatment.