Preeclampsia, gestational diabetes or other complications could put you at a higher risk for chronic diseases. Here’s how to keep your heart as healthy as possible.
IOWA CITY, Iowa — Women who develop complications during pregnancy may appear healthy within months of giving birth. But beneath the surface, subtle changes in their blood vessels could signal a higher risk of heart disease, stroke and diabetes years later.
That is the focus of research led by Dr. Anna Stanhewicz, an associate professor in the University of Iowa’s Department of Health, Sport, and Human Physiology, who is studying how pregnancy complications such as preeclampsia and gestational diabetes are linked to chronic disease later in life.
“We know that women who experience these adverse events in pregnancy like preeclampsia, high blood pressure for the first time, or gestational diabetes are at much higher risk for going on to develop chronic disease in the decades following,” Stanhewicz said.
Preeclampsia is characterized by high blood pressure that develops during pregnancy. Gestational diabetes occurs when blood sugar rises during pregnancy and typically resolves after delivery. In many cases, Stanhewicz said, women’s blood pressure and blood sugar return to normal after childbirth, leaving them “clinically indistinguishable from women that did not have complications in pregnancy.”
But the long-term data tell a different story.
“All of these pregnancy complications are associated with a higher risk of cardiovascular diseases,” she said. “Those can be heart diseases, diseases of the blood vessel. We also know that they’re at higher risk for things like stroke and also kidney disease.”
Women who experience gestational diabetes face particularly high odds of later developing Type 2 diabetes, which itself increases the risk of cardiovascular disease.
While we know about this association, we don’t know why it occurs. Stanhewicz’s lab is focused on what happens during the “window of time” after pregnancy, when women appear healthy but may already be experiencing subtle vascular changes.
“We’re trying to understand what’s happening in that window of time where these patients look clinically normal before they go on to have disease,” she said.
Her research has shown that even after blood pressure returns to normal following a hypertensive pregnancy, blood vessels may function differently.
“The blood vessels look a little bit different in that period of time after pregnancy,” Stanhewicz said. “What we’re really interested in trying to know is what specifically is happening at the level of the blood vessel in that window of time, so that we can intervene and improve blood vessel health before it progresses to disease.”
She said prevention is far more effective than treating disease after it develops.
“It’s much easier to prevent disease if we know what’s causing it than it is to treat disease once we’ve developed it,” she said.
For women with a history of pregnancy complications, she said communication with health care providers is critical. Because pregnancy care is often separate from long-term primary care, important risk factors can be overlooked.
“Having one of these events in pregnancy is a major risk factor,” Stanhewicz said. “Making sure that your primary care physician or whoever you see for clinical care knows about it is a really important part of discussing and managing chronic risk.”
In addition to regular screenings for blood pressure, cholesterol and blood sugar, she recommends lifestyle changes that support heart health.
“Sitting less, moving more, making sure that we’re eating healthy, specifically reducing the amount of salt in our diet, and getting lots of rest are all important things that we can do now that help prevent the progression of disease,” she said.
Stanhewicz’s work has earned national recognition. She recently received the 2026 Henry Pickering Bowditch Award from the American Physiological Society, which honors outstanding early-career researchers in physiology. As part of the award, she will deliver a lecture at the American Physiology Summit in April.
An emerging leader in women’s cardiovascular physiology, Stanhewicz said her long-term goal is to identify early warning signs that could help prevent chronic disease in women who experience pregnancy complications.
“This is a relatively understudied area,” Stanhewicz said, “so I am motivated to fill this gap in understanding with the hope that we can contribute to longer, healthier lives for these women.”
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