Prepregnancy Obesity and Pregnancy Outcomes Influence Midlife Cardiovascular Risk

A recent study has shed light on the connection between prepregnancy obesity, pregnancy complications, and future cardiovascular disease (CVD) risk. Published in the April 22 issue of the Journal of the American College of Cardiology, the research highlights that adverse pregnancy outcomes (APOs) partially mediate the relationship between a woman’s body mass index (BMI) before pregnancy and her risk for CVD later in life.

The study involved 4,269 pregnant women aged 18 and older, none of whom had hypertension or diabetes before pregnancy. These women were monitored throughout pregnancy and followed up approximately 11.6 years after childbirth. Findings revealed that women with obesity before pregnancy had higher average arterial pressure, triglyceride levels, and hemoglobin A1c at midlife. Specifically, gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) occurred in 13.8% and 10.7% of participants, respectively.

Importantly, the research determined that GDM mediated about 24.6% of the link between prepregnancy obesity and increased hemoglobin A1c, while HDP accounted for around 12.4% of the connection between obesity and elevated mean arterial pressure. These findings suggest that pregnancy complications serve as markers indicating future cardiovascular risk, unveiling key vascular and metabolic pathways affected by excess body weight before pregnancy.

The study emphasizes the importance of addressing prepregnancy BMI and managing pregnancy complications as part of strategies to reduce long-term cardiovascular risks. Recognizing APOs early can serve as a valuable intervention point to improve women’s health outcomes across their lifespan.

For more details, see the full study: Jaclyn D. Borrowman et al, "Prepregnancy Adiposity, Adverse Pregnancy Outcomes, and Cardiovascular Disease Risk in Midlife," Journal of the American College of Cardiology (2025). source: https://medicalxpress.com/news/2025-04-adverse-pregnancy-outcomes-association-prepregnancy.html