Adverse pregnancy outcomes should be considered lifelong risk factors for ischaemic heart disease and prompt early intervention, say researchers behind a large population-based study.

The US and Swedish team found that women who had experienced preterm delivery, small size for gestational age, pre-eclampsia, other hypertensive disorders of pregnancy or gestational diabetes had an elevated risk of ischaemia up to 46 years later.

“Our findings underscore the importance of including adverse pregnancy outcomes in the evaluation of cardiovascular risk for women in primary care, as well as in specialty clinic settings,” they reported in The BMJ.

Their retrospective study included nearly 2.2 million Swedish women with a first singleton delivery during 1973-2015, of whom 30% experienced at least one major complication of pregnancy.