A scoping review exploring women’s experiences of cardiometabolic pregnancy complications and future cardiovascular health implications

Why Pregnancy Stories Matter for Heart Health

Pregnancy is often seen as a brief chapter in a woman’s life, but for many women it acts like a stress test that can reveal future health risks. This article pulls together findings from hundreds of studies to ask a simple but powerful question: how do women experience serious pregnancy complications, and what do those experiences tell us about their long‑term heart and metabolic health? By listening to women, their families, and their healthcare teams, the authors show that what happens in pregnancy can shape health for years to come—and that better support during and after pregnancy could help prevent diabetes and heart disease later in life.

Pregnancy Complications and Later Health

The review focuses on four cardiometabolic pregnancy complications: high blood sugar first diagnosed in pregnancy (gestational diabetes), high blood pressure conditions such as pre‑eclampsia, babies that grow poorly in the womb, and spontaneous preterm birth. Although these problems look different on the surface, they share a common thread: they put great strain on a woman’s blood vessels and metabolism. Mounting evidence shows that women who experience any of these complications are more likely to develop type 2 diabetes and cardiovascular disease in the years after giving birth. Major heart organizations now view these pregnancies as early warning signs and key moments when prevention could begin.

What the Researchers Set Out to Map

Rather than measuring blood tests or drug effects, this scoping review mapped the landscape of qualitative research—studies based on interviews, focus groups, surveys with open questions, and similar methods. The authors searched seven large databases up to early 2025 and screened over ten thousand papers. In the end they identified 689 relevant articles, including 623 original research studies and 66 reviews. These studies included the voices of nearly twenty thousand women from every world region, as well as healthcare professionals, partners, and community members. The team then organized the studies along a “continuum of care,” from prevention in pregnancy to treatment during pregnancy and ongoing care after birth.

What Women Talk About Most

Across the four conditions, different concerns rose to the surface. For gestational diabetes and hypertensive disorders of pregnancy, most research focused on how women managed these conditions day‑to‑day—changing their diet, monitoring blood pressure, taking medications, and attending extra appointments. Many women described barriers to information, patchy follow‑up after birth, and worry about developing diabetes or heart disease later in life. For preterm birth and fetal growth restriction, the emphasis shifted toward emotional and social experiences: shock at an early delivery, anxiety about a small or fragile baby, stress in neonatal units, and the challenge of breastfeeding and parenting under pressure. In these areas, the mother’s own long‑term cardiometabolic health received far less attention than the baby’s immediate needs.

Making Sense of Hundreds of Studies

To spot common threads across such a large body of work, the authors used text‑analysis software that clusters frequently linked ideas from article abstracts into visual “concept maps.” In gestational diabetes and hypertensive pregnancy, the most prominent themes centered on women, health, and care, with clear links to lifestyle changes, medical management, and—especially for blood pressure disorders—future cardiovascular risk. For preterm birth and growth‑restricted babies, themes revolved around mothers, infants, milk, emotions, and social support, with little explicit discussion of later heart health. This suggests that many women and clinicians may not yet see these complications as signals of future cardiometabolic risk, even though medical research indicates they are.

Gaps, Opportunities, and Next Steps

The review also highlights who is being heard and who is not. Most studies come from Europe and North America, with fewer from South America and other under‑resourced settings, and there is very little qualitative work on fetal growth restriction. Few studies follow women from before pregnancy through pregnancy and well into the postpartum years, so we know little about how awareness and behavior change over time. Still, the sheer growth of qualitative research in recent years offers a rich foundation for designing better services—such as combined heart and pregnancy clinics, clearer follow‑up pathways after complicated births, and more flexible options like telehealth for women juggling infant care and their own medical needs.

What This Means for Women and Families

In plain terms, the article concludes that certain complicated pregnancies are early warning signs for future diabetes and heart disease—and that women’s own stories provide a roadmap for prevention. Women want clear, consistent information, emotional and practical support, and care that extends into what some call the “fourth trimester” after birth. By taking pregnancy history seriously, and by building services that respond to women’s lived experiences, health systems could turn these high‑risk pregnancies from frightening episodes into crucial chances to protect long‑term heart health.

Citation: Xu, W., Wisnewski, M., Kindsvater, C. et al. A scoping review exploring women’s experiences of cardiometabolic pregnancy complications and future cardiovascular health implications. npj Cardiovasc Health 3, 11 (2026). https://doi.org/10.1038/s44325-026-00107-8

Keywords: pregnancy complications, women’s heart health, gestational diabetes, preterm birth, cardiovascular risk