Pregnancy Complications Signal Higher Risk of Heart and Kidney Disease

A large study of British women has found that complications during pregnancy—whether in the most recent pregnancy or years earlier—leave lasting marks on heart and kidney health. Researchers tracking more than 1.4 million women over an average of four years discovered that certain pregnancy troubles signal a substantially elevated risk of developing serious cardiometabolic and kidney conditions later in life.

The research, published in BMJ Medicine, examined women registered with general practitioners across the United Kingdom between 2000 and 2022. Hospital records were cross-referenced to identify which women had experienced pregnancy complications, then followed to see who developed cardiovascular disease, type 2 diabetes, high blood pressure, or chronic kidney disease in the years that followed. The findings paint a picture of pregnancy as a kind of stress test on the body—one that can reveal vulnerabilities that persist long after delivery.

Gestational diabetes emerged as perhaps the starkest predictor. Women who developed diabetes during pregnancy faced a sevenfold increase in their risk of developing type 2 diabetes later. They also showed elevated rates of high blood pressure and cardiovascular disease. High blood pressure during pregnancy and preeclampsia—a serious condition marked by dangerously elevated blood pressure and protein in the urine—proved similarly consequential. These conditions more than tripled the rate of hypertension in subsequent years and approximately doubled the risk of chronic kidney disease. Cardiovascular disease and type 2 diabetes showed smaller but still meaningful increases.

What surprised researchers was the breadth of complications that appeared linked to later health problems. Postnatal depression following the most recent pregnancy increased the risk of all four major cardiometabolic-renal outcomes by between 35 and 56 percent. Miscarriage, stillbirth, placental abruption (where the placenta detaches prematurely from the uterine wall), and preterm birth all showed associations with at least one of these conditions, though the increases were more modest than those seen with gestational diabetes or preeclampsia.

The researchers emphasize an important distinction: these findings do not prove that pregnancy complications cause later disease. Rather, the complications function as clinical markers—signals that a woman's body may be at higher underlying risk. A woman who experienced gestational diabetes, for instance, may have metabolic vulnerabilities that both triggered the pregnancy complication and will later increase her diabetes risk. The study cannot untangle cause from correlation.

The work fills a meaningful gap in existing research. Previous studies had largely focused only on the most recent pregnancy, overlooking the possibility that complications from years earlier might still matter. Few had examined chronic kidney disease at all. By drawing on a large primary care database that reflects the broader U.K. population in terms of geography, age, and economic deprivation, the authors were able to capture a more complete picture than smaller, more specialized studies could provide.

Still, limitations remain. The researchers lacked data on diet and physical activity—factors that influence both pregnancy outcomes and later cardiometabolic health. Ethnicity information was missing for roughly one-fifth of the study group, which matters because pregnancy complications and cardiometabolic disease vary significantly across ethnic groups. These gaps mean some of the observed associations might reflect unmeasured differences between women rather than true biological links.

The authors argue that these findings should reshape how doctors approach women's health after pregnancy. Rather than treating pregnancy complications as isolated events, clinicians should obtain a complete reproductive history and use the postpartum period as a critical window for risk assessment. Women with a history of gestational diabetes, preeclampsia, or other adverse pregnancy outcomes might benefit from earlier screening, lifestyle interventions, or preventive medications—strategies that could reduce their risk of heart disease, kidney disease, or diabetes before those conditions develop. The question now is whether incorporating pregnancy history into existing risk prediction models will actually improve doctors' ability to identify which women need the most aggressive prevention.