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Summary of Nature Communications https://doi.org/10.1038/s41467-026-72580-9
Dr. Hooman Kamel et al.
Points
A comprehensive analysis of over two million first pregnancies indicates that pregnancy serves as a physiological stress test that amplifies a person’s baseline cardiovascular risk by seven times.
Researchers found that the relative risk of heart complications remains consistent across all ages, although older patients experience more total events due to their higher baseline risk levels.
Common complications identified in the clinical data included venous thromboembolism, heart failure, and cardiomyopathy, with approximately ten percent of survivors requiring long-term nursing care or specialized home health services.
Absolute risk increases remained stable at three excess events per one thousand pregnancies until age thirty-one, before rising to ten excess events per one thousand pregnancies by age forty-four.
The study emphasizes that clinicians should prioritize managing blood pressure and cholesterol in young adults to reduce baseline cardiovascular risks before they enter the high-stress period of pregnancy.
Summary
This study utilized deidentified claims data from 2,710,983 patients with a first pregnancy across 11 states (2016–2021) to evaluate the relationship between maternal age and pregnancy-related cardiovascular complications. By using patients as their own controls and comparing the pregnancy and postpartum periods against a one-year baseline control phase, researchers sought to determine if age independently increases pregnancy-specific risk or merely reflects accrued baseline cardiovascular risk. Findings confirmed that pregnancy and the postpartum period are associated with a seven-fold higher risk of major adverse cardiovascular events (MACE) compared to baseline.
Of the 13,744 patients who experienced a MACE, 12,059 occurred during the pregnancy or postpartum period, while 1,685 occurred during the control phase. Venous thromboembolism, cardiomyopathy, and heart failure were the most frequent events, while cerebrovascular hemorrhages and strokes remained rare but debilitating. Crucially, the seven-fold relative risk increase relative to a patient’s baseline did not vary with maternal age. Absolute risk increases remained stable at approximately 3 excess events per 1,000 pregnancies until age 31, then rose steadily to 10 excess events per 1,000 pregnancies by age 44.
The results suggest that aging does not drive pregnancy-specific mechanisms of cardiovascular failure; instead, pregnancy acts as a uniform physiological stress test that amplifies existing baseline risk. Among the 13,744 individuals with MACE, 240 deaths were recorded, and nearly 10% of survivors required long-term rehabilitative or home health care. These data indicate that pre-pregnancy cardiovascular optimization and aggressive management of blood pressure and cholesterol are critical for reducing maternal morbidity, regardless of patient age or racial background.
Link to the article: https://www.nature.com/articles/s41467-026-72580-9
References
Kamel, H., Riley, L. E., Son, M., Karas, M. G., Roman, M. J., De Sancho, M. T., Fink, M. E., Liberman, A. L., & Navi, B. B. (2026). Maternal age and pregnancy-related cardiovascular complications. Nature Communications, 17(1), 4066. https://doi.org/10.1038/s41467-026-72580-9
