Uteroplacental disorders linked to elevated cardiovascular risk for two decades

Researchers linked Dutch perinatal-registry and national hospital-admission data for 1,669,681 nulliparous women with singleton pregnancies from 2000 to 2022. In this population-based cohort, Cox models assessed cardiovascular disease (CVD) after uteroplacental disorders, adjusting for confounders. Median follow-up was 11 years (IQR 6–17 years).

A history of any uteroplacental disorder was associated with higher overall CVD risk (adjusted hazard ratio [aHR] 1.70, 95% CI 1.67–1.74). Risks were significantly elevated for premature hypertension, atherosclerosis, ischaemic heart disease, cardiac arrest, cardiomyopathy, heart failure and cerebrovascular disease. Associations were similar after pregnancy-induced hypertension, preeclampsia, fetal growth restriction or fetal death; risks after spontaneous preterm birth were less elevated. Many relative risks were highest shortly after pregnancy but remained elevated beyond 10 years. Hypertension risk was most pronounced after hypertensive disorders, and atherosclerosis risk after fetal growth restriction.

The findings identify a broad range of complicated pregnancies as markers of later CVD risk, not only preeclampsia. The observational design establishes associations, not causation, and does not determine which screening approach or timing improves outcomes. The authors highlight a need for early cardiovascular screening.