New research suggests that factors measured during pregnancy, including specific blood biomarkers, could offer a window into a woman’s long-term cardiovascular health. An analysis of data from nearly 39,000 pregnancies in Denmark, tracked over more than a decade, reveals associations between certain pregnancy-related factors and the subsequent development of cardiovascular disease (CVD).
The study, published in JAMA Cardiology on February 18, 2026, highlights the potential for identifying women at increased risk of heart problems years after childbirth. While cardiovascular disease is often considered a condition affecting older adults, emerging evidence suggests that early life factors, including those experienced during pregnancy, can play a significant role in long-term heart health. This research builds on a growing body of function exploring the link between reproductive health and cardiovascular outcomes.
Biomarkers and Pregnancy Complications Linked to CVD Risk
Researchers analyzed data from 38,455 pregnancies reaching at least 22 weeks of gestation, excluding those with pre-existing cardiovascular disease. A subset of 2,056 women from the Odense Child Cohort provided blood samples during pregnancy, around 12 and 29 weeks’ gestation, allowing for the measurement of several key biomarkers. These included soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), high-sensitivity cardiac troponin I (hs-cTnI), and N-terminal pro–B-type natriuretic peptide (NT-proBNP). The median maternal age was 30.4 years, and the median pre-pregnancy body mass index was 23.4 kg/m², according to the study.
Over a median follow-up period of 11.9 years, 28 women (1.4%) in the biomarker cohort developed CVD, encompassing stroke, coronary artery disease, atrial fibrillation, and heart failure. The analysis revealed that adverse pregnancy outcomes were associated with a 76% higher risk of CVD (adjusted hazard ratio [aHR] 1.76. 95% CI 1.38–2.24). Specifically, hypertensive disorders of pregnancy (HDPs) were linked to a 119% higher likelihood of developing CVD during follow-up (aHR 2.19; 95% CI 1.55–3.08).
Third-Trimester Biomarkers Show Promise for Prediction
Interestingly, the study found that biomarker measurements taken later in pregnancy – at 29 weeks’ gestation – were more informative than those taken earlier. Higher concentrations of hs-cTnI and sFlt-1 at 29 weeks were independently associated with increased CVD risk (aHRs 1.33 and 1.50 per 1-standard deviation increase, respectively). Other biomarkers, including NT-proBNP and PlGF, did not demonstrate a significant association with future CVD.
When researchers evaluated the predictive power of different models, they found that incorporating maternal age, systolic blood pressure, and non-high-density lipoprotein cholesterol yielded an area under the receiver operating characteristic curve (AUC) of 0.67. However, combining maternal age with third-trimester sFlt-1 levels further improved predictive performance, achieving an AUC of 0.75. This suggests that sFlt-1, measured in the third trimester, could be a valuable addition to existing risk assessment tools.
Limitations and Future Directions
The researchers acknowledge several limitations to their study. The relatively little number of cardiovascular events limited the statistical power, and the study population was primarily of Northern European descent, potentially limiting the generalizability of the findings to other populations. The study’s design cannot establish a causal relationship between the biomarkers and CVD; it only demonstrates an association. It’s possible that these biomarkers indicate a shared vulnerability to both pregnancy complications and cardiovascular disease, rather than directly causing the latter.
Despite these limitations, the authors conclude that pregnancy presents a valuable opportunity for early cardiovascular risk assessment. If confirmed by further studies, these biomarkers – particularly sFlt-1 measured in the third trimester – could help identify women who might benefit from earlier cardiovascular monitoring and preventive strategies. Further research is needed to validate these findings in more diverse populations and to determine the optimal strategies for translating this knowledge into clinical practice.
Disclaimer: This article provides informational content and should not be considered medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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