Gestational Diabetes Increases Risk of Worse Postpartum Cardiovascular Health

Patients that have a history of gestational diabetes, especially those older than 35 years, have an increased risk of significantly worse postpartum cardiovascular health (CVH) within the first 2 decades. Investigators of the study published in the Journal of the American Heart Association aimed to determine the long-term impact of gestational diabetes using the Life’s Essential 8 (LE8) metrics.¹

The Life’s Essential 8 is a measurement created by the American Heart Association, which is used for improving and maintaining cardiovascular health. When a patient has better cardiovascular health, it can help to lower the risk for heart disease, stroke, and other major health issues. The 8 categories include eating better, being more active, quitting using tobacco, getting a healthy amount of sleep, managing weight, controlling cholesterol, managing blood sugar, and managing blood pressure.²

“Current research on the cardiovascular consequences of gestational diabetes predominantly focuses on clinical CVD end points (eg, myocardial infarction, stroke) or early vascular dysfunction markers,” the authors of the study said.¹ “By combining continuous scoring with multidimensional domain integration (behavioral and biomedical), LE8 enables sensitive detection of subclinical CVH impairment. This combination makes LE8 particularly well suited for identifying early deviations from optimal CVH in populations at elevated risk, such as women with a history of gestational diabetes.”

Methods and Results of the Study

In the study, investigators aimed to assess the association between gestational diabetes history and postpartum CVH in women as well as the association across different postpartum periods. Data from the National Health and Nutrition Examination Survey was included, specifically 6 cycles from 2007 to 2018. Investigators included patients 20 to 80 years old as well as information about prior diagnoses of diabetes, sugar diabetes, or gestational diabetes during pregnancy. For LE8, patients were scored between 0 and 100 for each component, and an unweighted average was derived. Patients who had 80 to 100 points signified high CVH, 50 to 79 points signified moderate CVH, and scores of 0 to 49 indicated low CVH.¹

Of the participants, 6071 reported not having gestational diabetes, and 650 reported that they did. The overall averaged LE8 score was 63.72. Patients who had gestational diabetes were younger at screening at approximately 45 years compared with 53 years for those who did not. They were also more likely to be non-Hispanic white and have some college education.¹

Patients with a history of gestational diabetes also had lower LE8 scores by approximately -3.88 points as well as lower biomedical domain scores by -7.88 points compared with those who did not have gestational diabetes. However, there were no significant differences for the behavioral domain scores. The greatest reduction in overall LE8 scores was observed among non-Hispanic white patients, and the largest decrease in biomedical domain scores was among Hispanic participants.¹

In a secondary analysis, investigators found that gestational diabetes was associated with elevated body mass index, fasting glucose, hemoglobin A_1c, systolic blood pressure, and diastolic blood pressure. Further, patients with a history of gestational diabetes had lower CVH scores compared with those who were not diagnosed, with women diagnosed before age 35 years having a reduction of 3.37 points and those after age 35 years having a greater reduction of 5.87 points. Specifically, for those who were diagnosed, patients at or after age 35 years had significantly poorer CVH compared with those diagnosed before 35 years.¹

The Impact of Gestational Diabetes on Heart Health

In an editorial by the American Heart Association, authors discuss gestational diabetes as a risk factor for developing type 2 diabetes and cardiovascular disease later in life. They estimated that gestational diabetes impacts 250,000 women annually in the United States alone. The authors added that women who were previously diagnosed with gestational diabetes are at a 7-fold increase of T2D as well as an increased risk of CVD within 10 years postpartum.³

“Maternal health during pregnancy is pivotal in shaping overall postpartum health. As a prevalent obstetric complication, gestational diabetes adversely impacts both pregnancy outcomes and maternal CVH,” the authors of the current study wrote.¹ “This study highlights pregnancy as a crucial window for the improvement of postpartum CVH, emphasizing that well‐timed interventions during this phase can profoundly influence mothers’ long‐term health trajectories.”

READ MORE: Women’s Health Resource Center

Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips straight to your inbox.

REFERENCES

1. Fan YJ, Zu P, He LP, et al. Gestational Diabetes History and Cardiovascular Health Assessed by Life's Essential 8 across Postpartum Intervals. J Am Heart Assoc. Published online January 14, 2026. doi:10.1161/JAHA.125.044298

2. American Heart Association. Life's Essential 8. Accessed January 16, 2026. https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8

3. Green JB. Cardiovascular Consequences of Gestational Diabetes. Circulation. 2021;143(10):988-990. doi:10.1161/CIRCULATIONAHA.120.052995