UK study finds pregnancy complications linked to heart and kidney risks

More than 1.4 million women in the United Kingdom were analyzed in a new study published in BMJ Medicine, revealing that complications during pregnancy significantly elevate the risk of developing cardiometabolic-renal conditions later in life. The research indicates that issues such as gestational diabetes, high blood pressure, and postnatal depression are associated with increased likelihoods of cardiovascular disease, type 2 diabetes, hypertension, or chronic kidney disease.

Scope of the UK analysis

The authors searched a primary care database for women who had been pregnant and registered with a GP between January 1, 2000, and December 31, 2022. This data was linked to hospital records to identify specific pregnancy complications. The cohort was followed for an average of four years, allowing researchers to track health outcomes across both the most recent and previous pregnancies.

Specific condition associations

Gestational hypertension and pre-eclampsia more than tripled the rate of hypertension and approximately doubled the rate of chronic kidney disease in later life. Smaller increases were observed for cardiovascular disease and type 2 diabetes. Gestational diabetes showed a sevenfold higher rate of type 2 diabetes, along with increased rates for hypertension and cardiovascular disease.

Post-natal depression following the latest pregnancy increased the rate of all four cardiometabolic-renal outcomes by 35-56%. Additionally, miscarriage, stillbirth, placental abruption, and preterm birth in either the latest or previous pregnancies were associated with modestly higher rates of one or more outcomes. Babies born small or large for their gestational age also showed links to at least one cardiometabolic-renal condition.

Study limitations and conclusions

The authors note that while the link between gestational diabetes and high blood pressure with subsequent type 2 diabetes, cardiovascular disease, and chronic kidney disease is established, evidence for other complications like miscarriage and postnatal depression has been limited. Most prior studies focused only on the most recent pregnancy and rarely examined chronic kidney disease.

This observational study does not imply causation; rather, the complications function as clinical markers of underlying risk. Limitations include a lack of data on dietary habits and physical activity, with ethnicity data missing for around a fifth of the group. However, the use of a large GP database reflecting the UK population’s geography, deprivation, and age is cited as a strength.

"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," the authors conclude. They suggest further research is needed to understand the mechanisms and to determine if adding pregnancy history to existing risk models improves prediction of future heart, kidney, and metabolic health.