Pregnancy complications such as gestational diabetes, hypertension, and postnatal depression significantly elevate women’s subsequent risk of developing cardiometabolic-renal conditions, according to a U.S. study published in BMJ Medicine that followed more than 1.4 million women over an average of four years.
Women who experience complications during their latest or previous pregnancies face a heightened danger of cardiovascular disease, type 2 diabetes, chronic kidney disease, and high blood pressure in later life, a large longitudinal study reveals. Researchers analyzed data from general practitioner databases linked with hospital records across England between January 1, 2000, and December 31, 2022, identifying over 1.4 million women with and without pregnancy complications. Distinct disparities also appear across demographic groups; for example, a Canadian national study published in the Canadian Medical Association Journal found that Black people in Canada had an increased risk of severe maternal morbidity (SMM)—encompassing life-threatening conditions such as preeclampsia, hemorrhage, sepsis, heart conditions, uterine rupture, and kidney failure—compared with white people. That national study included data on almost 1.5 million births from 2012 to 2023, drawing from Canada’s 2021 long-form census linked with national birth, hospitalization, immigration, and tax information databases across all provinces and territories excluding Quebec. Black individuals experienced a rate of 47.8 per 1,000, whereas white individuals recorded 27.7 per 1,000.
Cardiometabolic Risks Tied to Gestational Hypertension and Diabetes
The study found distinct statistical increases in chronic conditions depending on the specific pregnancy complication recorded. Gestational hypertension and preeclampsia more than tripled the rate of subsequent hypertension and approximately doubled the rate of chronic kidney disease, alongside smaller increases in cardiovascular disease and type 2 diabetes. Meanwhile, gestational diabetes was associated with a sevenfold higher rate of type 2 diabetes, alongside increased rates of hypertension and cardiovascular disease. Other chemical and biological factors during or before pregnancy can further compound risks. Julia Varshavsky, assistant professor in the Department of Health Sciences at Northeastern University, studies how everyday chemical exposures shape health during pregnancy and beyond, with researchers noting that keeping all the required blood flow moving is hard on the heart as blood volume must increase by up to 50% by the end of gestation. Varshavsky’s lab found that the odds of hypertension later in pregnancy more than doubled as exposure to per- and poly-fluoroalkyl substances (PFAS) increased, with results suggesting first-time mothers and women carrying girls were most at risk. In addition, an investigation published in BMC Public Health utilized data from 630,968 women in South China’s Guangdong Province who intended to conceive between 2014 and 2018, demonstrating that pre-pregnancy infection-related exposures heavily boost the likelihood of congenital heart defects in offspring, with the regional birth defects registry identifying 1,312 affected infants, or approximately 0.21 percent.
Researchers also identified well-established associations as well as less common connections. Postnatal depression following a latest pregnancy increased the rate of all four cardiometabolic-renal outcomes by 35% to 56%. Other events—such as preterm birth, miscarriage, stillbirth, placental abruption, and babies born either small or large for their gestational age—were linked to modestly higher rates of at least one of these health conditions.
Clinical Implications and Reproductive History Assessment
Because the investigation is observational, and so does not imply that the pregnancy complication causes any subsequent disease, the authors emphasize that the complication functions as a clinical marker of underlying risk,
according to the study authors.
The study’s authors conclude that these insights advocate for gathering comprehensive reproductive backgrounds and leveraging the postpartum phase as an ideal window for evaluating risks and implementing cardioprotective prevention measures for individuals who have experienced problematic pregnancies. Study limitations included a lack of data on dietary habits and physical activity, as well as missing ethnicity data for roughly one-fifth of the study group.
Readers should consult qualified medical professionals regarding personal health concerns, risk factors, or postpartum care strategies.
