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Pregnancy complications and stress linked to long-term cardiovascular risk

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Pregnancy complications may leave women more vulnerable to the long-term heart effects of stress, a recent study suggests.

A study of more than 3,000 women in their first pregnancy found persistently higher stress levels were associated with higher blood pressure after pregnancy, specifically in women who had adverse pregnancy outcomes including preeclampsia, preterm birth, having a baby that was small for gestational age, meaning smaller than expected for that stage of pregnancy, or stillbirth.

Among women who experienced these complications, higher stress levels over time were associated with blood pressure that was 2 mm Hg higher than that of the low-stress group during the years two to seven after delivery.

This was not the case among women who did not experience adverse pregnancy outcomes.

Virginia Nuckols, lead author of the study and a postdoctoral fellow in the University of Delaware’s department of kinesiology and applied physiology, said: “For women who were having babies for the first time and had complications, referred to as adverse pregnancy outcomes, we found that higher stress levels over time were associated with higher blood pressure levels 2-to-7 years after delivery.

“This suggests that women who had pregnancy complications may be more susceptible to the negative effects of stress on their heart health, and taking steps to manage and reduce stress could be important for protecting long-term heart health.”

The researchers analysed records of 3,322 first-time mothers aged 15 to 44 who did not have high blood pressure before pregnancy.

The women were enrolled at 17 medical centres in eight US states, were pregnant with one baby and were having their first child. According to the authors, 66 per cent of participants self-identified as white, 14 per cent as Hispanic and 11 per cent as Black.

Blood pressure and stress levels were measured during the first and third trimesters, and again two to seven years after delivery.

Stress was assessed using the Perceived Stress Scale, a standard questionnaire that asks how often people feel situations are uncontrollable, unpredictable or overwhelming.

Those who experienced moderate to high stress levels were often younger, between 25 and 27 years of age, had higher body mass index, a measure based on height and weight, and lower educational attainment.

The authors said it is not yet clear exactly how higher stress leads to higher blood pressure in women who had pregnancy complications, and that several factors are likely to be involved.

Nuckols added: “Future studies should examine why women with a history of adverse pregnancy outcomes may be more susceptible to stress-driven increases in blood pressure and test whether stress reduction interventions can actually lower cardiovascular risk for these women.”

High blood pressure during pregnancy can have lasting effects on maternal health, including preeclampsia, eclampsia, stroke or kidney problems, according to the American Heart Association’s 2025 guideline for the prevention, detection, evaluation and management of high blood pressure in adults.

Monitoring blood pressure before, during and after pregnancy is crucial to help prevent and reduce the risk of long-term complications.

Laxmi Mehta is chair of the American Heart Association’s Council on Clinical Cardiology and director of preventive cardiology and women’s cardiovascular health at The Ohio State University Wexner Medical Center, and was not involved in the study.

Mehta said;’ “This study highlights the powerful connection between the mind and heart, emphasising the importance of stress management, particularly for those who have experienced adverse pregnancy outcomes.

“For the clinical care team, it reinforces the need to proactively assess and address stress as part of the comprehensive care we provide to our patients.

“Future research on whether targeted interventions to reduce or manage stress has a meaningful impact on long-term cardiovascular outcomes will be important as well.”

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Home blood pressure checks could lower heart risks for new mothers – study

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Home blood pressure checks after hypertensive pregnancy could cut the risk of heart attack, stroke and potentially early death, research suggests.

Women who regularly monitored their blood pressure in the weeks after giving birth, and had doctors tailor their medication if needed, had better functioning arteries nine months later than those who received routine care.

When the medication was adjusted to account for blood pressure changes, the women ended up with less stiff arteries, an effect researchers estimated could reduce the future risk of heart attack or stroke by 10 per cent.

Paul Leeson, professor of cardiovascular medicine who led the study, said the findings suggested that the weeks after birth provided a “powerful and often overlooked opportunity” to protect women’s future health.

“By simply monitoring blood pressure at home, new mothers with hypertensive pregnancies can protect their bodies from future damage,” he said.

High blood pressure, in the form of gestational hypertension or pre-eclampsia, where there are signs of organ damage, affects 5 to 10 per cent of pregnant women.

The condition can damage the mother’s organs and endanger the baby’s life.

Beyond the immediate threat to mother and baby, hypertension in pregnancy can raise the risk of long-term problems, with women three times more likely to develop high blood pressure and twice as likely to have heart disease later in life.

The Oxford team recruited 220 women who developed hypertension in pregnancy. All were on blood pressure medication but were due to reduce their dosage and eventually stop taking the drugs.

In the study, 108 women had standard care in which their medication was reduced based on a few blood pressure checks in the eight weeks after giving birth.

The remaining 112 women used a monitor to check their blood pressure at home each day.

They entered the readings into an app shared with doctors who, if needed, changed their medication day to day, with the aim of giving them better control of their blood pressure.

The new approach led to much better control of the women’s blood pressure, and in tests six to nine months later the women had less stiff arteries.

Stiff arteries are less effective at expanding and contracting, which can drive high blood pressure and ultimately the formation of clots that can block blood vessels and cause heart attacks and strokes.

Trials are now under way to find effective ways of rolling out blood pressure monitoring to women after hypertensive pregnancies. One option is for specialist NHS clinics to deliver the care.

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, which funded the work, said the results highlighted a crucial window after birth when paying close attention to blood pressure could help protect women’s heart health for years to come.

“We now look forward to seeing results from larger studies with longer follow-up to see how this might save women’s lives,” she said.

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More than half of women with gestational diabetes face harmful stigma, research reveals

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More than half of women with gestational diabetes report stigma from healthcare staff, family, friends and wider society, new research shows.

A survey of 1,800 UK women found widespread emotional distress at diagnosis of the condition, a form of high blood sugar that develops during pregnancy, with effects lasting beyond birth.

Gestational diabetes affects around one in 20 pregnancies in the UK, and the findings highlight the wider toll on women diagnosed with the condition.

The study was funded by Diabetes UK and led by researchers at King’s College London and University College Cork.

Dr Elizabeth Robertson, director of research and clinical at Diabetes UK, said: “Stigma can have a dangerous and devastating impact on pregnant women diagnosed with gestational diabetes, particularly at a time when emotions and anxieties may already be heightened.

“We know that stigma can lead to shame, isolation and poorer mental health, and may discourage people from attending healthcare appointments, potentially increasing the risk of serious complications.

“This research highlights the urgent need for better support systems, based on understanding and empathy to ensure no one feels blamed or judged during their pregnancy.”

More than two-thirds of women, 68 per cent, reported anxiety at diagnosis, while 58 per cent felt upset and 48 per cent experienced fear.

The psychological impact continued beyond birth, with 61 per cent saying the condition negatively affected their feelings about future pregnancies.

Nearly half of women, 49 per cent, felt judged for having gestational diabetes, while 47 per cent felt judged because of their body size.

More than 80 per cent felt other people did not understand gestational diabetes, and more than a third, 36 per cent, concealed their diagnosis from others.

Gestational diabetes stigma was also common in healthcare settings, with 48 per cent reporting that professionals made assumptions about their diet and exercise, and more than half, 52 per cent, feeling judged based on their blood glucose results.

Many women described a loss of control and a sense of disruption during pregnancy.

Nearly two-thirds, 64 per cent, felt they were denied a normal pregnancy, while 76 per cent reported a lack of control over their pregnancy.

More than a third, 36 per cent, felt abandoned by healthcare services after giving birth, and one in four, 25 per cent, continued to experience depression or anxiety postpartum.

Focus group participants described harmful stereotypes, including assumptions that they were ‘lazy’, had ‘poor eating habits’ or ‘lacked willpower’.

Comments from family and friends included remarks such as “should you be eating that?” and “you must have eaten too much, that’s why you have gestational diabetes.”

The researchers are calling for targeted interventions alongside structured emotional support for women during and after pregnancies affected by gestational diabetes, to improve both mental and physical health outcomes.

Professor Angus Forbes, lead researcher from King’s College London, said: “Stigma and emotional distress are far more common in women diagnosed with gestational diabetes than many realise.

“Everyday interactions, even with those who mean well, can deepen this harm, shaping women’s emotional wellbeing and the choices they feel able to make.

“It’s clear that meaningful action is needed to protect women’s mental and physical health.”

Risk factors for gestational diabetes include living with overweight or obesity, having a family history of type 2 diabetes, and being from a South Asian, Black or African Caribbean or Middle Eastern background.

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NIPT or NT scan? Why the 2026 evidence supports doing Both

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Article produced in association with London Pregnancy Clinic

One of the most common questions in early pregnancy: NIPT or the nuchal translucency (NT) scan – do I really need both? The 2026 evidence gives a clear answer.

The two tests look at different things, and doing them together is how first-trimester screening works at its best.

This is not a debate between old and new technology. NIPT is a genuine advance in detecting chromosome abnormalities from a maternal blood sample.

The NT scan is the first detailed look at how the fetus is forming. What each sees, the other largely cannot.

What NIPT actually tells you

NIPT – non-invasive prenatal testing – analyses fragments of fetal DNA circulating in the mother’s blood. Taken from around 10 weeks, the test measures chromosome proportions to flag the common trisomies: trisomy 21 (Down syndrome), trisomy 18 (Edwards) and trisomy 13 (Patau).

Most panels include fetal sex and sex-chromosome aneuploidies. Extended NIPT adds selected microdeletion syndromes – most commonly 22q11.2 (DiGeorge syndrome) – and the newest whole-genome platforms can detect copy-number variants down to around 1 Mb across every chromosome.

What NIPT does not look at is anatomy. It tells you whether the chromosomes are numerically correct.

It cannot tell you how the heart, brain, spine, kidneys or abdominal wall are forming, because it analyses DNA, not structure.

The NHS offers NIPT as a second-line screening test, reserved for women who receive a higher-chance result from the combined test – precisely because NIPT is best understood as one part of a wider screening picture rather than the whole of it.

What the NT scan actually tells you

The NT scan is an ultrasound performed at 11 to 14 weeks that measures the nuchal translucency – a small fluid-filled space at the back of the fetal neck.

Protocols developed by the Fetal Medicine Foundation, the group that pioneered first-trimester screening under Professor Kypros Nicolaides at King’s College Hospital, combine the NT measurement with additional markers: nasal bone, ductus venosus flow, tricuspid regurgitation, and maternal serum biomarkers (PAPP-A and free β-hCG).

More importantly, the scan is the first structural assessment of the fetus.

Major anomalies already visible at 11-14 weeks include absence of the cranial vault, large body-wall defects such as omphalocele and gastroschisis, megacystis, severe cardiac defects with abnormal four-chamber views, and skeletal dysplasias.

An increased NT measurement itself – even with a completely normal chromosome result – is associated with a notable rate of structural heart defects and monogenic syndromes that NIPT cannot detect.

Why the combination outperforms either test alone

Taken together, NIPT and the NT scan give complementary coverage.

For the common trisomies, NIPT is more sensitive than the NT scan alone. Pooled data place detection of trisomy 21 above 99 per cent with a false-positive rate around 0.1 per cent.

Combined first-trimester screening without NIPT, using NT and serum markers alone, reaches approximately 90 per cent detection – and up to 95 per cent when nasal bone, ductus venosus and tricuspid flow are added – at a 3 to 5 per cent false-positive rate.

For that specific endpoint, NIPT is the more accurate test.

The NT scan picks up almost everything NIPT misses: structural anomalies, early markers of monogenic syndromes, confirmation of viability, accurate dating, twin chorionicity, and placental position.

An increased NT with a normal NIPT result shifts the clinical conversation toward syndromes like Noonan, Kabuki and the skeletal dysplasias – conditions with single-gene origins rather than chromosomal ones.

Working out which is which often requires genetic testing beyond NIPT. Carrier screening and expanded genetic panels – including those offered at Jeen Health – cover the single-gene territory that NIPT does not address.

When the combination matters most

Several patient groups have most to gain from doing both:

  • Women conceiving after IVF or with donor gametes, where maternal age and fertility treatment each subtly shift risk profiles
  • Women aged 35 and over, where baseline chromosomal risk is higher and soft markers are more likely
  • Anyone with a previous pregnancy affected by an anomaly or loss, where reassurance matters
  • Twin pregnancies, where NIPT performance depends on fetal fraction and structural assessment is more complex
  • Women who have had a raised or borderline result on earlier screening markers

Chromosomes and anatomy are two separate clinical questions. Each needs its own answer.

What happens if the tests disagree

Disagreements between NIPT and the NT scan are not failures of either test – they are the reason both are done.

  • NIPT low-risk, NT raised: consider monogenic syndromes, structural cardiac assessment, and early anomaly ultrasound follow-up
  • NIPT higher-chance, scan normal: confirmatory diagnostic testing (CVS or amniocentesis) before any major decision
  • NIPT no-call: repeat sampling, gestational age check and clinical review – a no-call itself is associated with an increased chromosomal risk
  • Both abnormal: a clear indication for specialist fetal medicine review and early diagnostic testing

Professional guidance from the RCOG supports this complementary approach, emphasising that NIPT is a screening rather than a diagnostic test, and that its results are most useful when interpreted alongside ultrasound findings.

Practical guidance for 2026

The most efficient way to run both tests is in a single appointment window, between 10 and 14 weeks, with the blood sample taken first and the scan performed on the same visit.

Results typically return within 5 to 10 working days for standard NIPT panels, and same-day for the scan itself.

This is the logic behind the SMART Test at London Pregnancy Clinic – extended NIPT paired with a full first-trimester ultrasound in a single appointment, delivering both chromosomal and structural information in one visit. For most patients, it removes the false choice of picking one over the other.

The wider picture

The question of NIPT versus NT scan has a settled clinical answer in 2026: the two tests examine different aspects of the pregnancy, and the most complete first-trimester assessment uses both.

For a pregnancy a woman wants to carry with the fullest possible picture, both tests belong in the first-trimester window. The question worth asking is which clinic offers them together, with the pre- and post-test care that makes the results usable.

If you are deciding on first-trimester screening, a consultation with a fetal medicine specialist is the most useful first step.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS, Fetal Medicine Foundation and RCOG standards as at April 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with London Pregnancy Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

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