A child’s future heart health may be partially shaped before birth, reports a new Northwestern Medicine study that finds pregnancy complications are associated with poorer cardiovascular health in offspring more than 20 years later.
The study found that young adults whose mothers had high blood pressure during pregnancy (either pregnancy-related hypertension, preeclampsia, or eclampsia) had more signs of early artery damage, high blood pressure, high body mass index, and high blood sugar than their peers.
The authors said their study adds to growing evidence that cardiovascular risk can be transmitted across generations through a combination of biological, environmental, and behavioral factors.
That means we must help people stay healthy from childhood to adolescence so that if or when someone becomes a parent, they can pass on the best opportunities for good health to their children. ”
Dr. Nilay Shah, senior study author and assistant professor, Feinberg School of Medicine, Northwestern University
How to conduct research
Shah and colleagues evaluated approximately 1,350 mother-child pairs from the Family Futures and Child Well-Being Study, which enrolled mothers and children at birth in 20 U.S. cities from 1998 to 2000. The children were then followed until adulthood.
For the first time, Northwestern scientists used birth admission records to identify whether mothers experienced pregnancy complications, such as high blood pressure during pregnancy, gestational diabetes (high blood sugar during pregnancy), and preterm birth (before 37 weeks of pregnancy).
Three complications of pregnancy are on the rise, affecting nearly one in four pregnancies in the United States.
The research team then analyzed the cardiovascular health of the 22-year-old offspring using blood pressure measurements, blood tests, BMI assessments, and carotid ultrasound to look for signs of artery damage.
Finally, the scientists compared participants who were exposed to each pregnancy complication to those who were not, adjusting for factors such as income, education, birth weight differences, and smoking during pregnancy.
Main findings
Participants whose mothers developed high blood pressure during pregnancy had the following symptoms around age 22:
- Increase in BMI index (BMI points +2.8)
- Increased diastolic blood pressure (+2.3 mm Hg)
- Increased blood sugar level (+0.2% HbA1c)
- Arterial walls are thick (~0.02 mm)
Although the difference in arterial wall thickness may seem small, the study authors said it corresponds to approximately 3 to 5 years of increased vascular aging. This means your arteries appear older and less healthy than expected, increasing your risk of heart disease in the future.
Other pregnancy complications also show long-term effects.
- Exposure to gestational diabetes was associated with worse blood pressure and evidence of arterial thickening
- Being born prematurely was associated with higher blood sugar levels
“Most heart disease is preventable”
As pregnancy complications are on the rise in the United States, Shah said this study provides compelling evidence that improving health before and during pregnancy may help reduce the risk of heart disease in future generations.
“There is evidence that the health status of parents at and during pregnancy influences the health status of their children,” he said. “Therefore, promoting good health from an early age, such as regular exercise, healthy eating, smoking cessation, and getting enough sleep, is not only beneficial for the individual, but in doing so may also benefit the health of future generations.”
Shah also emphasizes that risk is not destiny.
“The good news is that most heart disease is preventable,” he says. “Experiencing high blood pressure or high blood sugar during pregnancy or having a child early does not absolutely mean that your child will have poor health as an adult. However, it is a good idea to start paying attention to your child’s health behaviors now.
“What children learn in early childhood sets the foundation for lifelong health. If you have questions about whether your child’s behavior is healthy or are considering making changes, contact your child’s pediatrician for advice and guidance.”
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Reference magazines:
Lamb, E.L. others (2026) Adverse pregnancy outcomes and cardiovascular health in early adult offspring. JAMA network open. DOI:10.1001/jamanetworkopen.2026.6783. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2849006.
