Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis
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OBJECTIVE: To quantify the risk of future cardiovascular diseases, cancer, and mortality after pre-eclampsia. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Embase and Medline without language restrictions, including papers published between 1960 and December 2006, and hand searching of reference lists of relevant articles and reviews for additional reports. REVIEW METHODS: Prospective and retrospective cohort studies were included, providing a dataset of 3,488,160 women, with 198,252 affected by pre-eclampsia (exposure group) and 29,495 episodes of cardiovascular disease and cancer (study outcomes). RESULTS: After pre-eclampsia women have an increased risk of vascular disease. The relative risks (95% confidence intervals) for hypertension were 3.70 (2.70 to 5.05) after 14.1 years weighted mean follow-up, for ischaemic heart disease 2.16 (1.86 to 2.52) after 11.7 years, for stroke 1.81 (1.45 to 2.27) after 10.4 years, and for venous thromboembolism 1.79 (1.37 to 2.33) after 4.7 years. No increase in risk of any cancer was found (0.96, 0.73 to 1.27), including breast cancer (1.04, 0.78 to 1.39) 17 years after pre-eclampsia. Overall mortality after pre-eclampsia was increased: 1.49 (1.05 to 2.14) after 14.5 years. CONCLUSIONS: A history of pre-eclampsia should be considered when evaluating risk of cardiovascular disease in women. This association might reflect a common cause for pre-eclampsia and cardiovascular disease, or an effect of pre-eclampsia on disease development, or both. No association was found between pre-eclampsia and future cancer.
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Women with a history of HDP have a higher risk of developing hypertension, CVD and CVD-related morbidity and mortality than women with uncomplicated pregnancies.
“Moreover, women with a history of HDP are at a higher risk of developing hypertension, CVD and CVD-related morbidity and mortality than women with uncomplicated pregnancies97,177–188”
From A global view of hypertensive disorders and diabetes mellitus during pregnancy (2022) · cites this paper as [179]
The Results report higher later hypertension, cardiovascular disease, and fatal cardiovascular-event risks after pre-eclampsia; the Discussion also reports higher future hypertension and cardiovascular disease risk after pregnancy-induced hypertension. The claim extends these findings to all hypertensive disorders of pregnancy (HDP), whereas the Methods specify pre-eclampsia and a separate analysis of pregnancy-induced hypertension, with comparison groups defined by absence of pre-eclampsia rather than uncomplicated pregnancy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIt has become increasingly clear that several conditions in pregnancy predispose both mother and offspring for later disease, including hypertension, cardiovascular disease, and type 2 diabetes.
“It has become increasingly clear that several conditions in pregnancy predispose both mother and offspring for later disease, including hypertension, cardiovascular disease, and type 2 diabetes.49”
From Nutrition in adolescents: physiology, metabolism, and nutritional needs (2017) · cites this paper as [49]
The Discussion (page not available in our copy) reports increased later hypertension and cardiovascular disease among women with a history of pre-eclampsia. The paper does not establish later disease in offspring or an increased risk of type 2 diabetes, and it addresses pre-eclampsia rather than several pregnancy conditions. Its Introduction also leaves open whether the cardiovascular association reflects a shared cause or damage during pregnancy, so the claim's causal wording is stronger than the source supports. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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- Authors
- Bellamy, L., Casas, J.-P., Hingorani, A. D., & Williams, D. J.
- Affiliations
- Imperial College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- British Heart Foundation (GB)
- University College London (GB)
- Corresponding author
- Williams, David J
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-11-01
- Volume
- 335
- Issue
- 7627
- Pages
- 974
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2072042
- OpenAlex
- W2051213492
- Semantic Scholar
- d9e2ad67777b50bb3ba731bbc9b5b1963bd3bfbb
- Cited by
- 2,552
- References
- 34
- Citations by year
- 2026: 105 · 2025: 113 · 2024: 123 · 2023: 146 · 2022: 163 · 2021: 172 · 2020: 197 · 2019: 178 · 2018: 182 · 2017: 145 · 2016: 144 · 2015: 159 · 2014: 145 · 2013: 154 · 2012: 126
- FWCI
- 10.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institute for Health and Care Research
- British Heart Foundation
- University College London Hospitals NHS Foundation Trust
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- preeclampsia, cardiovascular disease, cancer risk, hypertension, ischemic heart disease, stroke, venous thromboembolism, breast cancer, mortality, women's health
- MeSH terms
- Age Factors, Cardiovascular Diseases, Cause of Death, Female, Follow-Up Studies, Humans, Neoplasms, Pre-Eclampsia, Pregnancy, Risk Factors
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