Continuation of the NuMoM2b Heart Health Study

Project Summary/Abstract Adverse pregnancy outcomes (APO), including hypertensive disorders of pregnancy, preterm birth, small for gestational age birth, and gestational diabetes, are associated with cardiovascular disease (CVD) risk in mothers. The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (nuMoM2b) collected biospecimens during pregnancy and extensive

phenotyping data for 10,038 nulliparous women from 2010-13. The nuMoM2b Heart Health Study is comprised of 7,003 nuMoM2b participants who were recontacted at least once after their nuMoM2b birth, 4,508 of whom returned for an in-person CVD risk factor assessment 2-7-years later. This cohort is currently in a second phase of followup, with multiple ancillary studies

running in parallel, and is uniquely positioned to address questions about the complex interplay of APOs and maternal CVD. Unfortunately, the network is facing several challenges related to the downstream effects of the COVID-19 pandemic. We propose four activities to address these challenges, improve participant engagement, and expand the network infrastructure:

• Increasing participant incentives. Prior increases in incentives have resulted in improved rates of survey completion. We plan an additional increase, reflecting the significant time investment and commitment of our study participants. • Increasing study network support. Downstream effects of the COVID-19 pandemic

include reduced participant engagement with research studies and increased rates of missed study visits, which increase the time required to complete planned activities. Increasing the level of support to network sites will improve their ability to respond to these challenges and build network resilience.

• Implementing a pilot study of remote visits. Since the original time of enrollment in nuMoM2b, about 30% of study participants have moved away from their network sites and are no longer located within a travel distance that allows them to attend in-person study visits. We propose to complete a pilot study of remote visits using a national

network of mobile phlebotomists to evaluate remote visits as a strategic approach to maintaining engagement of these participants. • Sustaining infrastructure. To further improve participant engagement, the network will convene a Participant Engagement Committee and expand its online informational

content. In addition, analytic support to network investigators will be expanded and recently collected data will be prepared for release to support timely reporting of results.