Year: 2026
Type: article
Abstract: Introduction Health literacy is a key social determinant of health. Adequate health literacy has been associated with better obstetric and general adult health outcomes. However, its relationship with cardiovascular health during and after pregnancy is not well known. We aimed to estimate associations between health literacy and cardiovascular health in early pregnancy and postpartum. Methods This is a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐be (nuMoM2b) study and its prospective follow‐up phase, the nuMoM2b Heart Health Study. Participants who completed the Rapid Estimate of Adult Literacy in Medicine–Short Form (REALM‐SF) in the second trimester (16–21 weeks of gestation) and a 2–7 year postpartum study visit were included. Health literacy was classified as inadequate (REALM‐SF score <7) or adequate (≥7) using standard scoring procedures. The primary outcomes were cardiovascular health in early pregnancy and 2–7 years after the first birth, assessed using a modified Life's Essential 8 (LE8) score, which includes health behaviors (diet, physical activity, sleep health, and nicotine exposure) and health factors (body mass index, blood pressure, blood glucose, and lipid levels). Secondary outcomes included LE8 subcomponents. Multivariable linear regression models, which adjusted for maternal age, insurance type, and family income, were used to evaluate associations of health literacy with LE8 overall scores and its subcomponents. Results Among 4424 participants eligible for analysis, 3599 (81.4%) had adequate health literacy. Those with adequate health literacy were older, more likely to identify as non‐Hispanic White, and more likely to have higher income, higher education, and private insurance coverage. Participants with adequate health literacy had higher early pregnancy LE8 scores (79.9 ± 13.3 vs. 73.0 ± 14.2, p < 0.001), a relationship that persisted after adjustment (aβ 3.6, 95% confidence interval [CI], 1.8–5.4). This association was driven by body mass index, diet, physical activity, and sleep subcomponents. Similarly, LE8 scores 2–7 years after birth were higher among those with adequate health literacy (80.1 ± 13.8 vs. 72.9 ± 14.6, p < 0.001; aβ 3.2, 95%, CI, 0.8–5.6), primarily due to healthier measures of body mass index, diet, physical activity, nicotine exposure, and sleep. Conclusion Among nulliparous women, adequate health literacy scores in early pregnancy were associated with better cardiovascular health during pregnancy and several years after first birth.
Source: Pregnancy
DOI: 10.1002/pmf2.70487
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,225
Funders: Cedars-Sinai Medical Center, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Child Health and Human Development, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, Pregnancy as a Window to Future Cardiovascular Health: Adverse Pregnancy Outcomes, Indiana Clinical and Translational Sciences Institute, Pregnancy as a Window to Future Cardiovascular Health, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, UCLA Clinical and Translational Science Institute, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk , Adverse Outcomes in Nulliparous Pregnancies: The Ohio Collaborative, G41180667, G4172225262, G4206105981, Pregnancy as a Window for Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, G4853807150, G5248658720, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, Pregnancy as a Window to Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, Pregnancy as a Window to Future Cardiovascular Health, Prevention of Preterm Birth in high Risk Nulliparous Patients, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, Pregnancy as a Window to Future Cardiovascular Health, Clinical and Translational Science Collaborative of Cleveland, Institute for Clinical and Translational Science, Dissecting the Genetic Etiology of Preterm Birth in Nulliparous Women, Continuation of the NuMoM2b Heart Health Study
OpenAlex ID: W7223551010