A Life-course Approach to Cardiovascular Health: Is the Perinatal Period a Sensitive Period for Future Health?

Women’s health, specifically cardiovascular health, is broadly under-researched globally. Evidence-based interventions are improving health outcomes for men, but not for women. The influence of sex- and gender- based experiences throughout the life-course are therefore vital areas to research to improve cardiovascular health for all.

The perinatal period, from preconception to two years postpartum, has been hypothesised as both a ‘sensitive period’ and a ‘window’ into future cardiovascular health. Furthermore, the experience of adverse pregnancy outcomes have been linked with the onset of cardiovascular disease. Conversely, periods of lactation after pregnancy have been associated with reduced burden of cardiovascular disease.

The influence of lactation, however, is complex. Entangled with other factors such as maternal physical and mental health, maternal education, maternal age, socio-economic position, migration history and indeed adverse pregnancy outcomes; it is an intricate area to explore causal pathways in relation to cardiovascular health. The roles of social and skilled support in the perinatal period add further complexity; it is not established whether the social support received in the perinatal period may lead to improved cardiovascular outcomes, or if it is the social support which may lead to higher breastfeeding rates that improves cardiovascular outcomes this way.

This project proposes to identify detailed biological and social determinants of infant feeding practices and examine how these are related to the experience of adverse pregnancy outcomes. Secondly, these now-defined types of biological and social determinants and varying infant feeding practices, will be investigated in relation to biological markers of cardiovascular health such as blood pressure, weight, body mass index, adiposity and waist circumference across the life-course. This approach aims to identify potential pathways in the determinants of future health, building evidence towards understanding which interventions are most beneficial for mothers and families in the perinatal period.