Preeclampsia is a serious complication of pregnancy that can affect a woman’s health beyond pregnancy. For a long time, it has been clear that women who experience preeclampsia have a greater chance of developing high blood pressure, kidney disease, and heart disease later in life. However, one important question has remained: can the amount of protein in the urine during preeclampsia help identify which women are most at risk for long-term health problems? Protein in the urine signals that the kidneys are under stress, and it is one factor doctors use to diagnose preeclampsia. In this cohort study, more than 286,000 women in Denmark were followed for up to 23 years to discover whether higher levels of protein in the urine during pregnancy are linked to future health issues.
Researchers found that women who had preeclampsia were more likely to develop high blood pressure, chronic kidney disease, and cardiovascular disease than women who did not have preeclampsia. However, the amount of protein in the urine made the biggest difference for kidney health. Not surprisingly, women with higher levels of protein in their urine during preeclampsia had a much greater chance of developing chronic kidney disease in the years after pregnancy. Within 10 years of giving birth, about 5 out of every 100 women with higher protein levels developed chronic kidney disease, compared with about 1 out of every 100 women with lower protein levels. Women with higher protein levels also had a greater risk of developing high blood pressure later in life. Although preeclampsia increased the risk of cardiovascular disease overall, having more protein in the urine did not appear to increase that risk further.
These findings suggest that protein in the urine is more than just a sign of preeclampsia during pregnancy—it may also provide important clues about a woman's future health. For preeclampsia survivors, this research reinforces the importance of continuing medical care after pregnancy, even if you feel well. Regular blood pressure checks and routine kidney health testing may help identify problems early when treatment can be most effective. The study also suggests that women with higher levels of protein in their urine during preeclampsia may benefit from closer long-term follow-up. While this research does not mean everyone with preeclampsia will develop kidney or heart disease, it highlights another way doctors may be able to identify women who could benefit from extra monitoring and preventive care.
Take Home Message
Women who have had preeclampsia are at higher risk for high blood pressure, chronic kidney disease, and heart disease later in life. This Danish study showed that higher protein in the urine during preeclampsia is strongly linked to increased risk of future kidney disease and, to a lesser extent, high blood pressure. Testing for protein in the urine may help doctors decide who needs ongoing follow-up and early preventive care after pregnancy. More research in the U.S. will help us better understand how protein in the urine during preeclampsia affects long-term kidney and heart health. Whether or not a patient had proteinuria, a history of preeclampsia places survivors at risk for long-term health issues beyond pregnancy.
Click here for a free printable worksheet patients and providers can use to start the long-term health conversation in the 6 months to 2 years postpartum.
Citation: A. H. S. Vestergaard, H. M. L. Svane, S. K. Jensen, et al., “ Proteinuria in Preeclampsia and Long-Term Risk of Maternal Kidney and Cardiovascular Disease: A Population-Based Cohort Study,” BJOG: An International Journal of Obstetrics & Gynaecology(2026): 1–10, https://doi.org/10.1111/1471-0528.70265.
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