Pregnancy complications linked to higher risk of cardiac and renal health conditions

Pregnancy complications were linked to higher rates of heart, metabolic and kidney conditions in later years, a study of more than 1.4m women found.

Complications in a woman’s latest or previous pregnancies were associated with increased rates of cardiovascular disease, type 2 diabetes, hypertension and chronic kidney disease.

Gestational diabetes, high blood pressure during pregnancy and postnatal depression were linked to all four conditions.

Preterm birth, miscarriage, stillbirth, placental abruption and babies born small or large for their gestational age were associated with at least one.

The authors concluded: “Several pregnancy complications, including those occurring in previous pregnancies, were associated with an increased risk of cardiometabolic-renal conditions in the subsequent years after pregnancy.

“These findings support obtaining a full reproductive history and using the postpartum period as an opportune time for risk assessment and preventative cardioprotective strategies in women with a history of adverse pregnancy outcomes.”

Researchers analysed records from more than 1.4m women who had been pregnant and registered with a UK GP between 1 January 2000 and 31 December 2022.

Primary care records were linked with hospital data to identify pregnancy complications, and the women were followed for an average of four years.

Gestational hypertension and pre-eclampsia were associated with more than three times the rate of later hypertension and around twice the rate of chronic kidney disease.

Smaller increases were also seen in cardiovascular disease and type 2 diabetes.

Gestational diabetes was associated with a sevenfold higher rate of type 2 diabetes and increased rates of hypertension and cardiovascular disease.

Postnatal depression following the most recent pregnancy was associated with a 35 to 56 per cent increase in rates across all four heart, metabolic and kidney outcomes.

Miscarriage, stillbirth, placental abruption and preterm birth in the latest or a previous pregnancy were associated with modestly higher rates of one or more conditions.

Placental abruption occurs when the placenta separates from the inner wall of the womb before delivery.

The researchers said further work is needed to understand the mechanisms behind the associations and whether including a woman’s full pregnancy history in existing risk models could improve predictions of future heart, kidney and metabolic health.

The study was observational, meaning it cannot establish that pregnancy complications caused the later conditions. The researchers said the complications may instead act as clinical markers of underlying risk.

Limitations included a lack of information about diet and physical activity, while ethnicity data was unavailable for around a fifth of participants.