The impact of preeclampsia and gestational diabetes on future maternal cardiometabolic health

Introduction: Pregnancy is a time of significant maternal physiological change to meet the metabolic demands of the feto-placental unit. In cases of pregnancy complications, mal-adaptative physiological responses may occur, potentially impacting the health of both mother and fetus. Moreover, some maternal changes may persist beyond delivery. Although the clinical symptoms of preeclampsia (PE) and gestational diabetes mellitus (GDM) usually resolve post-partum, growing evidence suggests that these conditions confer a lifelong increased risk of cardiometabolic disease in affected women. This review aimed to summarise epidemiological evidence linking PE and GDM to future maternal cardiometabolic disorders, explore potential underlying mechanisms based on animal and small-scale human studies, and discuss implications for future research and postpartum clinical care. Methods: Targeted PubMed searches were conducted to search for relevant publications. Results: Data suggest that pregnancy complications may both reveal an underlying predisposition to cardiometabolic disease and induce lasting physiological changes that contribute to future health risks. Notably, women with a history of PE may have a 3-4-fold increased risk of cardiovascular disease, while those with prior GDM may face up to a 10-fold higher risk of developing type 2 diabetes. Conclusion: Pregnancy offers a valuable window into a woman’s future health, presenting a unique opportunity for preventative medicine for up to half of the world’s population.