From one pregnancy to the next: watch out for repeated complications

A new study shows that when gestational diabetes or hypertension recur, cardiovascular risks rocket

Montreal, December 5th, 2023 - Pregnant women sometimes develop gestational diabetes or gestational hypertension, complications that are associated with an increased risk of heart disease and stroke in the years following pregnancy. A new study based on Quebec data and conducted at the Research Institute of the McGill University Health Centre (RI-MUHC) shows that when women experience more than one episode of gestational diabetes or gestational hypertension, their risk of heart attack or stroke can double or even triple. With the help of their families, communities and healthcare professionals, these women would greatly benefit from taking steps to reduce their risk.

“Women who have had even one occurrence of gestational diabetes or gestational hypertension need support to take action. In women with more than one occurrence, the need for action is even more urgent. We hope our findings activate these individuals, their health care providers, their communities, and the government to find the tools to prevent heart disease and stroke”, says Dr. Kaberi Dasgupta, senior scientist in the Metabolic Disorders and Complications Program at the RI-MUHC and senior author of the study.

A large-scale study with striking results

The researchers included in their sample nearly half a million women who had had at least two deliveries. They excluded women who had diabetes or hypertension before becoming pregnant or between pregnancies. They then examined what had happened to these women after their second pregnancy, over an average period of more than 15 years, and calculated the risks using statistical programs.

The lowest risk women were the ones who didn’t have gestational diabetes or gestational hypertension in either pregnancy. Compared to them, the ones with one occurrence of either gestational diabetes or gestational hypertension in either pregnancy had a 50 percent higher chance of a heart attack or stroke in the future. Women with two occurrences had double the risk. Those with three or more occurrences had triple the risk.

“Pregnancy is usually a time when younger adults are interested in addressing health issues to improve the short and long term health of their families. We are hoping our work incentivizes mothers to consume heart-healthy foods, exercise routinely and regularly attend follow-up hospital visits after the birth of their baby,” says Joseph Mussa, PhD candidate in Epidemiology at McGill University, RI-MUHC trainee at the Centre for Outcomes Research and Evaluation and first author of the study.

The watchword: prevention

Heart disease and stroke are challenging conditions that can affect productivity and day-to-day functioning. Yet there are ways of reducing the risks. Being more physically active, eating more fruits and vegetables and less processed foods, and having opportunities and resources to be more active and eat in a healthy way can all lower heart attack and stroke risk.

"If women are supported in their prevention efforts, especially by their families and healthcare teams, the impact will be positive for their health and for all of those people with whom they are connected and who rely on them – their families, colleagues, friends, and communities," adds Dr. Dasgupta, who is also a full professor in McGill University's Department of Medicine.

This complex work was funded by the Heart & Stroke Foundation of Canada (Heart & Stroke), and the analyses were performed in the secure data centres of the Quebec Statistical Institute.

"We know that women who experience hypertension during two or more pregnancies are two to three times more likely to develop heart disease or stroke and two times more likely to die from cardiovascular disease before age 70,” says Diego Marchese, Executive Vice President, Mission, Research, Social Enterprise, Heart & Stroke. “Women face unique risk factors throughout their lifespan, including during pregnancy. Heart & Stroke is committed to supporting and expanding research to better understand women’s heart and brain health in Canada.”

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About the study

The study Considering gestational diabetes and gestational hypertension history across two pregnancies in relationship to cardiovascular disease development: A retrospective cohort study was conducted by  Joseph Mussa, Elham Rahme, Mourad Dahhou, Meranda Nakhla and Kaberi Dasgupta.

DOI: https://doi.org/10.1016/j.diabres.2023.110998

About the Research Institute of the McGill University Health Centre

The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC)—an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 450 researchers and around 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec—Santé (FRQS). rimuhc.ca

Media contacts

Fabienne Landry
Communications, Research, MUHC
[email protected]

Alicia D’Aguiar
Communications Advisor, Mission | Heart & Stroke
[email protected]