5 days ago
Your 3-Item Prepregnancy Health Checklist
May 28, 2025 — Planning a pregnancy? Go ahead, envision it: the birth, the name, the color scheme of the nursery.
But have you thought about squeezing in your cardiologist appointments between school pickups and soccer practice?
Probably not, but maybe you should: More moms than ever are at risk of heart problems around the time their child turns 10. They may even watch a tiny blood-pressure cuff get wrapped around their toddler's arm — because childhood high blood pressure is linked to mom's health during pregnancy.
In fact, a flurry of new science provides stark details about how prepregnancy health can impact your child's lifelong health — and your own during the prime parenting years.
'More women now than ever are entering pregnancy with risk factors such as obesity,' said Jaclyn D. Borrowman, PhD, a postdoctoral fellow in preventive medicine at Northwestern University Feinberg School of Medicine. About 40% of American women have obesity, and that could hit 60% by 2050, she said.
It's not just weight. A new analysis looked at eight factors affecting pregnancy health: sleep, diet, physical activity, blood pressure, prepregnancy diabetes, body mass index, cholesterol, and smoking history.
'While some may be aware of these risks, many aren't,' Borrowman said. 'Even when they are, it's not always easy to act on that knowledge.'
The first step in pregnancy planning, she said: Meet with your doctor before getting pregnant.
Here are three ways new research says you can optimize your own and your baby's lifelong health.
1. Manage Your Weight
Pregnancy is often called a 'window into your future health.' Pregnancy-related health problems like gestational diabetes or high blood pressure often lead to chronic health problems later in life. A new study connects the dots from prepregnancy health to pregnancy complications and to — about 11 years later — serious risk factors for heart trouble.
The key link: obesity heading into pregnancy, the researchers found.
'Even in those without pregnancy complications, we saw that obesity before pregnancy was linked to a higher risk of heart disease down the road,' said Borrowman, the study's author.
On average, the mothers in the study were around 30 years old when they gave birth and about 41 when heightened heart disease risk factors showed up in their medical records.
In a separate new study, a mother's weight during the first trimester was the strongest health factor (out of eight) associated with developing a gestational blood pressure condition.
Put simply: The lower the mother's body mass index, the lower the odds of developing these problems. That means every little bit of prepregnancy weight loss or weight management during pregnancy can make a big health impact.
Obesity is a complex disease with multiple causes, Borrowman stressed. It's not just about lifestyle but also 'things like family history, health conditions like thyroid problems or polycystic ovarian syndrome (PCOS), and where someone lives,' she said. If you're struggling, don't go it alone. Your primary care doctor can help guide you.
2. Improve Your Blood Pressure
'It's not all about weight,' said researcher Michael C. Honigberg, MD, a cardiologist at Mass General and assistant professor at Harvard Medical School.
While his study (mentioned above) found weight to be the strongest factor linked to blood pressure problems during pregnancy, it also showed that even small reductions in blood pressure before pregnancy can make a big difference — even for women without diagnosed high blood pressure.
Women whose systolic blood pressure (top number) was between 120 and 129 had 1.5 times greater odds of developing a blood-pressure-related pregnancy problem, compared with women who had normal blood pressure (when the top and bottom numbers are below 120 and 80, respectively).
Another new study showed that children whose mothers had high blood pressure during pregnancy were significantly more likely to have elevated blood pressure during childhood, and the problem worsened as the child got older (the study included measurements from ages 2 to 18). Children were at the highest risk if their mother had both obesity and high blood pressure during pregnancy.
Taken together, Honigberg said, these latest studies show that 'much of the risk associated with these pregnancy complications reflect prepregnancy cardiometabolic and cardiovascular health. Not all of it, but a lot of it.'
One overlooked problem with prepregnancy assessments, he said: Young women look healthy.
'We often ignore or brush off cardiometabolic risk factors in young patients because they're young, so they're fine,' he said. Conclusions about health risks of mothers and their children point toward 'a slightly glib summary of the way the medical system thinks about risk factors in young adults.'
3. Improve a Little Bit of Everything About Your Health
Honigberg's study created a score for pregnant women based on Life's Essential 8 — a set of health metrics defined by the American Heart Association to measure heart health. These include sleep, diet, physical activity, blood pressure, prepregnancy diabetes, body mass index, cholesterol, and smoking history.
The team then calculated women's odds of developing blood pressure problems during pregnancy, including preeclampsia and eclampsia. They analyzed how genetic predisposition compared to having a poor score for all eight health factors.
The upshot: Don't let genetics discourage you. Higher scores of Life's Essential 8 were linked to lower odds of gestational blood pressure problems — regardless of genetic risk.
True, weight and diabetes status were among the biggest single drivers. But by analyzing all health factors during the first trimester, this study uncovered other areas to focus on before and during pregnancy.
For example, increasing nightly sleep from less than four hours to at least seven can greatly lower risk, and so can increasing physical activity.
'Making lifestyle changes can be difficult, but small changes can make a huge difference in your overall health,' Borrowman said. 'Pregnancy can be an exciting time, but it also comes with a lot of unknowns and that can be stressful. The truth is, we all do the best we can with the information and resources we have.
'If you're currently pregnant and reading this, please know that taking the time to learn and care about your health already shows your deep commitment to giving yourself and your baby the best possible start. That matters and it makes a difference.'
