Adverse Pregnancy Outcomes and Long-Term Risk of Chronic Diseases: Evidence from the Findings of the Tehran Lipid and Glucose Study During a Quarter of a Century

Abstract

Context: Evidence supports that adverse pregnancy outcomes (APOs) might affect women's health in later life. This review summarizes the findings of the Tehran Lipid and Glucose Study (TLGS) on the association between APOs and long-term chronic diseases over the past two decades. Evidence Acquisition: This narrative review was conducted on TLGS-published articles on the association between APOs and long-term chronic disease over the last decades. The search for articles was performed on PubMed from 1999 to September 2025. Results: As of September 2025, nine peer-reviewed English-language articles have been published from the TLGS dataset. Studies showed that a history of hypertensive disorders of pregnancy (HDP) was associated with a twofold increased risk of hypertension, a threefold risk of diabetes, and a 1.3 times risk of dyslipidemia. Moreover, women with a history of preeclampsia were 3.62 times more likely to experience hypertension progression. Women with a history of gestational diabetes mellitus (GDM) had a 2.23 times risk of diabetes and a 1.85 times risk of cardiovascular disease (CVD). Having a history of preterm delivery increased the risk of chronic kidney disease (CKD) 2.68 times more than that of women without such a history. The risk of metabolic syndrome (METS) was increased by 8% in women with a history of pregnancy loss. Moreover, a history of one, two, or three APOs was associated with an increased risk of developing CVD, with the risk rising progressively as the number of APOs increased. Conclusions: Over the past two decades, the TLGS has published a number of peer-reviewed articles that collectively provide a unique perspective on the long-term health consequences of APOs. These studies indicate that pregnancy is not only an obstetric event but also a vital period for assessing women's long-term health. Women with a history of APOs require early preventive evaluations and ongoing monitoring to identify and treat chronic conditions linked to increased risks of premature mortality.