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.”

A blood test for endometriosis showed clinical promise after detecting cases missed by standard imaging, according to a clinical validation study.

HerAnova Lifesciences has published a peer-reviewed clinical validation study of its HerResolve blood test for endometriosis in the Journal of Minimally Invasive Gynecology, the official journal of the AAGL.

The multi-centre study enrolled 298 women of reproductive age across 11 clinical sites in the US, Europe and Hong Kong.

The study population was 75.8 per cent white, 9.7 per cent Black, 9.1 per cent Asian and 5 per cent non-white Hispanic participants.

It found the test identified 61.5 per cent of histologically confirmed endometriosis cases that were missed by transvaginal ultrasound and or MRI scans.

All results were validated against the gold standard of laparoscopic findings with histopathological tissue confirmation.

The headline numbers were an AUC of 0.944, specificity of 97.5 per cent and sensitivity of 80 per cent. The high specificity was a deliberate design choice, with the model optimised to minimise false positives and reduce unnecessary invasive procedures. Performance was also consistent across menstrual phases.

The blood test, called HerResolve, is a multi-omic blood-based assay that combines three serum microRNA biomarkers, three protein biomarkers, one steroid hormone, patient age and BMI into a machine learning algorithm to detect endometriosis.

Farideh Bischoff, chief medical officer at HerAnova and corresponding author of the study, said: “Endometriosis has long been one of the most underdiagnosed and undertreated conditions in women’s health.

“HerResolve was designed to work alongside existing imaging and clinical evaluation, filling a critical gap in non-invasive disease detection.”

The test is currently available at select IVF and reproductive medicine centres across the US and is positioned as a triage tool, helping identify patients who may benefit from further evaluation or empirical treatment rather than replacing surgery entirely, but potentially reserving it for treatment rather than diagnosis.

A prospective validation study is underway in geographically and ethnically diverse populations, and HerAnova is also pursuing longitudinal analyses to evaluate whether the assay can monitor treatment response over time.

Endometriosis affects approximately one in 10 women of reproductive age, yet the average diagnostic delay remains six to 11 years.

The current gold standard, laparoscopic surgery, is invasive, dependent on surgeon skill and not without risk, making a reliable non-invasive alternative one of the most sought-after tools in women’s health diagnostics.