History of preeclampsia, gestational diabetes mellitus, and the risk of cardiovascular disease

Preeclampsia and gestational diabetes mellitus (GDM) are common complications associated with pregnancy, which affect birth outcomes and are linked to a long-term cardiovascular disease (CVD) risk. 

A new study investigated whether the preeclampsia could be co-related to CVD, independent of GDM and if the association could change based on the patient’s body mass index (BMI) or GDM.

This nested case-control study was conducted in Sweden. Participants included women with a first CVD event between 1991 and 2008 who had been pregnant in the past. Mothers––of the same age and residing in the same geographic location––without a CVD history formed the control group. The associations between CVD and GDM, preeclampsia, and maternal BMI were evaluated. 

Overall, 2,639 cases and 13,310 controls were included in the study. The results revealed preeclampsia and GDM as independent risk factors for CVD. On adjusting with maternal BMI, the preeclampsia-CVD association did not significantly alter – amongst groups, normal weight, overweight, and obese. Further, on stratifying based on GDM/non-GDM, preeclampsia-CVD association did not notably differ. 

The results suggested that preeclampsia and GDM are independent risk factors for CVD risk in later life. The concomitance of both risk factors during pregnancy amounts to a major risk for later CVD. However, the association between preeclampsia and CVD is not modified by BMI variability. 

Therefore, effective CVD preventive programs are warranted for high-risk women – through structured follow-ups with preventive healthcare access to improve women’s long-term health.

Source: BJOG. 2023 Mar 27. doi: 10.1111/1471-0528.17454. Doi: 10.1111/1471-0528.17454