Key result
Preeclampsia is linked to ~81% higher risk of major cardiovascular events compared with matched controls.
Why the study?
The study aimed to evaluate the association between preeclampsia and early MACE and assess whether gestational age at diagnosis (EOPE vs LOPE) and severity are associated with distinct cardiovascular risk patterns to enhance postpartum surveillance.
Does preeclampsia (and its onset timing and severity) increase the risk of subsequent major adverse cardiovascular events (myocardial infarction, ischemic stroke, or heart failure) in postpartum women compared to women without preeclampsia?
Cohort (n=348,634)
Yes
Does preeclampsia (and its onset timing and severity) increase the risk of subsequent major adverse cardiovascular events (myocardial infarction, ischemic stroke, or heart failure) in postpartum women compared to women without preeclampsia?
Both early- and late-onset preeclampsia are independently associated with substantially elevated early postpartum risks of heart failure, stroke, myocardial infarction, and mortality, underscoring the need for postpartum cardiovascular surveillance particularly in women with severe early-onset disease.
Answers are grounded in this paper and cite their sources.
Preeclampsia history marks elevated early postpartum MACE risk; leaves open whether targeted surveillance improves outcomes.
Purpose: Our objective is to evaluate the association between preeclampsia and early major adverse cardiovascular events (MACE), including heart failure, stroke, and myocardial infarction. Additionally, we assessed whether the onset of preeclampsia (EOPE vs LOPE) affects cardiovascular risk differently. By utilizing a large, comprehensive, and nationwide dataset with strong longitudinal follow-up, we aim to evaluate whether gestational age at diagnosis is associated with distinct patterns of cardiovascular health, thereby enhancing postpartum surveillance and preventive strategies in clinical practice. Patients and Methods: In this nationwide cohort study using Taiwan’s National Health Insurance Research Database (2016– 2022), women with preeclampsia were matched 1:10 with controls by age, year, and residential area. The primary outcome was a composite of first hospitalization for myocardial infarction, ischemic stroke, or heart failure. Secondary outcome included all-cause mortality. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs). Results: Among 31,694 women with preeclampsia and 316,940 controls, 1.97% and 0.79% developed MACE, respectively. Preeclampsia was associated with increased risks of MACE (aHR 1.81; 95% CI, 1.64– 1.99), myocardial infarction (aHR 2.19; 95% CI, 1.34– 3.59), stroke (aHR 1.59; 95% CI, 1.41– 1.80), heart failure (aHR 3.85; 95% CI, 3.00– 4.95), and all-cause mortality (aHR 1.85; 95% CI, 1.50– 2.29). Both early- and late-onset preeclampsia were associated with elevated risk, with the largest point estimate observed in those with severe early-onset disease, particularly for heart failure (aHR 10.10; 95% CI, 6.57– 15.53). Conclusion: Preeclampsia is associated with substantially increased early cardiovascular risk. Both early- and late-onset disease warrant subsequent cardiovascular surveillance, particularly in severe cases.
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Chung et al. (2026) conducted a cohort in Preeclampsia in pregnancy (n=348,634). Preeclampsia (including early-onset <34 weeks and late-onset >=34 weeks, stratified by severity) vs. Pregnant women without preeclampsia matched 1:10 by maternal age group, residential area, and year of delivery was evaluated on Major adverse cardiovascular events (MACE), a composite of first inpatient hospitalization for acute myocardial infarction, ischemic stroke, or heart failure (aHR 1.81, 95% CI 1.64-1.99, p=<0.001). Preeclampsia was associated with an 81% increased risk of major adverse cardiovascular events compared with matched controls.
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