article · Pregnancy Hypertension
• BMI ≥30 does not increase overt 12-month cardiovascular complications. • BMI ≥30 increases 12-month markers of potential future cardiovascular risk. • In BMI ≥30, pre-eclampsia and age link to 12-month cardiovascular risk markers. To evaluate the impact of maternal postpartum body mass index on cardiovascular health at 12 months postpartum in a low-resource urban Black African population. Ugandan women (n = 653) were recruited from 20 weeks until labour onset at a national maternity hospital in urban Kampala. At 12 months postpartum, participants underwent cardiovascular assessment including echocardiography, pulse wave velocity, and blood pressure measurement. Multivariable regression models were used to assess associations between postnatal maternal body mass index and 12-month cardiovascular risk markers. Women with body mass index ≥ 30 kg/m 2 were more likely than women with body mass index < 30 kg/m 2 to have ≥1 cardiovascular marker above the 95th cohort-derived centile at 12 months postpartum (OR 1.69, 95% CI: 1.23–2.32, p = 0.001). Women with body mass index ≥30 kg/m 2 had increased left ventricular mass (p < 0.001), left ventricular (p < 0.001) and atrial (p < 0.001) diameters, and wall thickness (p = 0.02) compared to women with body mass index <30 kg/m 2 . Postnatal pulse wave velocity (p < 0.001) and blood pressure (p = 0.03) were higher in women with body mass index ≥30 kg/m 2 , although this was not associated with an increase in overt cardiovascular complications including reduced left ventricular ejection fraction (p = 0.08) or increased rates of hypertension (p = 0.91). Elevated postnatal maternal body mass index is associated with increased cardiovascular risk markers at 12 months postpartum, even after adjustment for relevant pregnancy complications, socioeconomic status, and maternal age. These findings suggest that postnatal weight management strategies merit exploration as interventions aimed at reducing the high risk of cardiovascular disease affecting Black African women in low-resource urban populations.
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DOI: 10.1016/j.preghy.2026.101480
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