Women who experience serious pregnancy complications like preeclampsia, gestational diabetes, or preterm delivery have a substantially elevated risk of developing peripheral artery disease (PAD) in later life, according to new research from UTHealth Houston. The finding adds to growing evidence that pregnancy outcomes can predict long-term cardiovascular health, offering a critical window for early intervention and monitoring.

What Is Peripheral Artery Disease and Why Should You Care?

Peripheral artery disease occurs when arteries become narrowed, restricting blood flow most often to the legs and feet. The condition affects millions of people worldwide and is frequently a precursor to serious complications like stroke, heart attack, and premature death. People with PAD may experience leg pain or cramping while walking, numbness, cold feet, or slow-healing sores on the feet or legs.

The new study analyzed data from more than 2 million women in Sweden who gave birth to single babies between 1973 and 2015. Researchers tracked long-term outcomes in women who experienced preterm delivery, preeclampsia (dangerously high blood pressure during pregnancy), gestational diabetes (diabetes that develops during pregnancy), or other adverse pregnancy outcomes.

"Our prior work has already shown that adverse pregnancy outcomes are associated with long-term risks of heart disease, stroke, and heart failure. This study builds on that work by showing that these women have an increased risk of peripheral artery disease, an important but understudied cardiovascular condition," said Casey Crump, MD, PhD, MPH, a professor in the Department of Family and Community Medicine at McGovern Medical School at UTHealth Houston.

Casey Crump, MD, PhD, MPH, Professor at McGovern Medical School at UTHealth Houston

How Can Pregnancy Complications Affect Your Arteries Years Later?

The exact biological mechanisms linking pregnancy complications to later artery disease are still being studied, but researchers believe that conditions like preeclampsia and gestational diabetes reflect underlying vascular and metabolic vulnerabilities. These same vulnerabilities can persist and worsen over decades, gradually damaging blood vessels and narrowing arteries.

The connection is significant because it suggests that pregnancy serves as an early warning system. Women who develop these complications may benefit from closer cardiovascular monitoring and preventive care starting immediately after childbirth, rather than waiting until symptoms appear years or decades later.

Steps to Protect Your Heart Health After a Complicated Pregnancy

• Schedule Regular Screenings: Women with a history of adverse pregnancy outcomes should speak with their doctor about monitoring blood pressure, blood sugar levels, and cholesterol regularly. These three markers are key indicators of future cardiovascular risk.
• Maintain a Healthy Weight: Keeping weight stable through balanced nutrition and regular physical activity helps reduce strain on the cardiovascular system and lowers inflammation in blood vessels.
• Avoid Smoking: Smoking damages artery walls and accelerates plaque buildup, making it one of the most modifiable risk factors for peripheral artery disease.
• Follow a Heart-Healthy Lifestyle: A diet rich in vegetables, whole grains, and lean proteins, combined with regular exercise, supports long-term vascular health and can slow or prevent artery narrowing.
• Stay Connected with Your Primary Care Doctor: Long-term follow-up care and open conversations with healthcare providers are essential for catching early signs of cardiovascular problems before they become serious.

Crump emphasized that the postpartum period represents a crucial opportunity for intervention. "Women with a history of adverse pregnancy outcomes who seem to be doing well may still have a higher risk that can emerge later in life," he noted. "It's never too late to lower the risk for peripheral artery disease".

Crump

The research team included Jingkai Wei, PhD, MSPH, from McGovern Medical School, and Jan Sundquist, MD, PhD, and Kristina Sundquist, MD, PhD, both from Lund University and Skåne University Hospital.

For women who experienced complicated pregnancies, the takeaway is clear: pregnancy complications are not just a concern for the immediate postpartum period. They signal a need for lifelong cardiovascular vigilance. By working closely with healthcare providers, maintaining healthy habits, and staying informed about personal risk factors, women can take meaningful steps to protect their heart and circulation for decades to come.