Pregnancy complications associated with later cardiometabolic and kidney disease in English cohort

A BMJ Medicine longitudinal study examined associations between pregnancy complications and subsequent cardiometabolic and kidney disease in 1,432,795 women aged 15-49 years. Researchers used the UK CPRD Aurum primary care pregnancy register from 2000 to 2022. Outcomes were first recorded diagnoses of cardiovascular disease, type 2 diabetes, hypertension and stage 3-5 chronic kidney disease; median follow-up across outcome cohorts was 4.1-4.3 years.

Of 72 associations examined, 51 remained statistically significant after correction for multiple testing. Gestational hypertension and pre-eclampsia were associated with more than threefold rates of subsequent hypertension and approximately doubled rates of chronic kidney disease. Gestational diabetes was associated with a sevenfold rate of type 2 diabetes and higher rates of hypertension and cardiovascular disease, but not chronic kidney disease.

Postnatal depression following the latest pregnancy was associated with higher rates of all four outcomes: hazard ratios were 1.36 for hypertension, 1.41 for diabetes, 1.56 for cardiovascular disease and 1.35 for chronic kidney disease. Miscarriage, stillbirth, placental abruption and preterm birth in the latest or earlier pregnancies were associated with modestly higher rates of one or more outcomes.

The findings support obtaining a full reproductive history and considering postpartum risk assessment and prevention. However, these observational associations do not establish causality or demonstrate benefits from a particular preventive intervention. This report is based on the abstract; full methods and absolute risks were unavailable in the supplied source.