When consequences of pregnancy complications develop later in life

For many women, pregnancy seems like it lasts far longer than nine months. Mounting evidence suggests they’re right — at least when it comes to the potential consequences of pregnancy complications years and even decades later.

Placing enormous demands on the heart, blood vessels, metabolism, and kidneys, carrying a baby acts as a “stress test.” When complications arise, they can serve as the first sign of cardiovascular risks that surface long afterward.

These complications can certainly be perilous at the time they happen. Among the most serious are preeclampsia (in which dangerously high blood pressure can impair the function of the heart, kidneys, and other organs) and gestational diabetes. But women who’ve had these conditions also face higher lifetime risks of high blood pressure, heart attack, stroke, diabetes, and other major health issues.

Many women still assume, however, that what happened during pregnancy stayed there — and that any complications ended when the baby showed up, says Dr. Brett Young, chair of the Department of Obstetrics and Gynecology at Harvard-affiliated Mount Auburn Hospital.

“There’s a lot of opportunity to educate women that the complications that come up in pregnancy are a window into future health for the ‘fourth trimester’ after birth and moving forward years and decades down the road,” Dr. Young says.

Revealing research

A variety of fresh studies reinforce the notion — which emerged more than 15 years ago — that cardiovascular disease after pregnancy is often tied to complications that occurred during pregnancy. Here are a few recent findings:

• Women who had high blood pressure or pre-eclampsia during pregnancy develop coronary artery disease an average of seven years earlier than women who didn’t have these complications, and they’re more likely to have a heart attack, according to a 2024 study in the Journal of the American College of Cardiology.
• Women who had preeclampsia are three to four times more likely to develop cardiovascular disease, while those who had gestational diabetes may face up to 10 times the risk of later type 2 diabetes, according to a research review published in the November 2025 issue of Acta Physiologica.
• Women who had preeclampsia are 45% more likely to be hospitalized for kidney disease in the 34 years after pregnancy, according to a study published online July 21, 2025, by the American Journal of Nephrology.

These same complications may also contribute to eventual memory and thinking problems due to damage to blood vessels supplying oxygen-rich blood to the brain. “We believe preeclampsia affects the lining of the blood vessels, and there’s more evidence it might increase the odds of certain types of dementia,” Dr. Young says.

Preventive strategies

But many women are not aware of these long-term health hazards. Health care providers may not routinely inquire about pregnancy complications, Dr. Young says, and medical intake forms may omit the question as well.

“Women typically feel much better after their pregnancy complication is over, and understandably they may not be aware of or may not want to think about potential health problems in the distant future,” she says.

It’s smarter to use your pregnancy history as a preventive tool. Dr. Young offers women who had complicated pregnancies these strategies to lower their long-term cardiovascular risks:

Share your pregnancy history with your clinicians. “Being proactive is always a good thing,” she says. “We always want patients to advocate for themselves and work as a team with their health care providers.”

Seek more aggressive monitoring. You should have your blood pressure, cholesterol, and blood sugar levels measured more frequently.

Eat heart-healthy foods. This is important for everyone, of course, but especially so for women who had preeclampsia or gestational diabetes. Emphasize nutrient-dense, high-fiber options such as leafy greens, berries, fatty fish, whole grains, nuts, and olive oil, and limit salt, processed sugar, and saturated fats.

Exercise. Regular physical activity lowers blood pressure, improves cholesterol and blood sugar levels, tamps down inflammation, and strengthens the heart. Major health organizations recommend 150 minutes of moderate-to-vigorous exercise each week and strength training at least twice weekly.

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