Pregnancy-Induced Hypertension Tied to Increased Long-Term Risk of Autoimmune Diseases: Study Finds

The study, which analyzed data from 289,564 women, revealed that those with pregnancy-induced hypertension faced a 1.87-fold higher risk of developing systemic lupus erythematosus, along with an elevated likelihood of multiple sclerosis, rheumatoid arthritis, and other autoimmune diseases. The risk increased with the severity of hypertension and remained consistent across different age groups. With follow-up data extending up to 18 years, the findings highlight the importance of long-term monitoring for affected women.

PIH, characterized by high blood pressure during pregnancy, includes conditions such as gestational hypertension and preeclampsia. While its immediate risks to both mother and baby are well-documented, emerging research suggests that its implications extend far beyond pregnancy, potentially predisposing affected women to autoimmune disorders in later life.

Against the above background, Chia-Chi Lung, PhD, Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan, and colleagues aimed to investigate the link between hypertensive disorders during pregnancy and the future risk of developing autoimmune diseases.

For this purpose, the researchers conducted a retrospective cohort study using TriNetX, a federated network of real-world data. They analyzed electronic medical records from 102 healthcare organizations within the Global Collaborative Network, covering 131 million patient records from 2006 to 2020. The study focused on women aged 16–45 years, comparing two cohorts: those with pregnancy-induced hypertension (including gestational hypertension, preeclampsia, or eclampsia) and those with normotensive pregnancies. Women with preexisting autoimmune diseases, hypertension, or complications before 20 weeks of gestation were excluded. Propensity score matching was applied to balance the groups.

The primary outcome assessed the long-term risk of autoimmune diseases over a follow-up period of up to 18 years, while the secondary outcome examined the impact of age and hypertension severity on this risk.

The study led to the following findings:

• Pregnancy-induced hypertension was observed in 13.4% of the study population.
• After propensity score matching, women with pregnancy-induced hypertension had a significantly higher risk of developing autoimmune diseases during long-term follow-up.
• The risk of systemic lupus erythematosus was notably higher (hazard ratio 1.87).
• Increased risks were also observed for multiple sclerosis, Addison disease, antiphospholipid syndrome, inflammatory bowel disease, mixed connective tissue disease, and rheumatoid arthritis.
• Women of advanced maternal age with pregnancy-induced hypertension had a similar risk of developing autoimmune diseases as younger women.
• The severity of pregnancy-induced hypertension was directly associated with a higher risk of autoimmune diseases.

The researchers found that women with a history of pregnancy-induced hypertension face a higher long-term risk of developing autoimmune diseases. Their findings highlight the need for continuous monitoring and early intervention, especially for those who experienced more severe forms of the condition. They emphasize the importance of further research to understand the underlying mechanisms better and develop targeted strategies to improve long-term health outcomes for these women.

Reference:

Shih, Yu-Hsiang MD; Yang, Chiao-Yu MPH; Lung, Chia-Chi PhD. Pregnancy-Induced Hypertension and Association With Future Autoimmune Diseases. Obstetrics & Gynecology ():10.1097/AOG.0000000000005871, February 27, 2025. | DOI: 10.1097/AOG.0000000000005871