Pregnancy complications still matter for heart and kidney health years later

Pregnancy is often seen as a short chapter. The complications that arise in it, however, can echo for years. Pre-eclampsia, gestational hypertension and gestational diabetes are often recorded and then left behind once the baby is home. A new study suggests that this may be a missed opportunity.

Steven Wambua and colleagues used primary care records from the Clinical Practice Research Datalink. They followed 1,432,795 women in England, aged 15 to 49. They looked at ten pregnancy complications from the latest and earlier pregnancies, and tracked cardiovascular disease, type 2 diabetes, hypertension and chronic kidney disease. Median follow-up was about 4.3 years, starting six months after delivery.

The results

• Pregnancy complications were associated with health issues later on, including high blood pressure, type 2 diabetes, heart disease and stroke, and chronic kidney disease.
• The strongest connections were with conditions commonly linked to pregnancy. Women who had gestational hypertension or pre-eclampsia in their latest pregnancy were more than three times as likely to develop high blood pressure later.
• Gestational diabetes was strongly associated with type 2 diabetes, with women developing it at about seven times the rate (hazard ratio 6.99).

What this means

The authors are careful about what this means. These are prognostic associations, not causal effects, and the hazard ratios should not be added together. Women with complications are also monitored more closely, so some of the signal may reflect more testing rather than more disease.

Primary care does not routinely use pregnancy history as a tool to estimate cardiovascular risk. QRISK3 and QDiabetes omit it, and the authors argue that researchers still need to test whether adding it improves prediction.

Primary care implications

For now, it is important to record a complete reproductive history during the postnatal review. Make sure to code pre-eclampsia, gestational hypertension, gestational diabetes and preterm birth in the record for future reference.

This paper serves as a reminder that the best time to ask about a pregnancy can be years after it has ended.

Reference

Wambua S, Singh M, Mohammed R, et al, on behalf of the MuM-PreDiCT Group. Pregnancy complications and risk of cardiometabolic-renal conditions in 1.4 million women in England: longitudinal study. BMJ Medicine. 2026;5:e003035.

Intended for UK healthcare professionals only. This article reports on published clinical data and does not constitute prescribing advice.