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Ann Robinson reviews the latest research Pregnancy and childbirth can be worrying times, and the news that adverse pregnancy outcomes are associated with an increased risk of dying younger will ramp up anxiety, but it also offers scope to shift the dial. This national Swedish cohort study of more than two million women found that any of five major adverse pregnancy outcomes (preterm delivery, small for gestational age, pre-eclampsia, other hypertensive disorders, and gestational diabetes) was associated with increased mortality risks that remained elevated up to 46 years later. The major causes of death included cardiovascular and respiratory disorders and diabetes. Pregnancy has been called a “natural stress test” that unmasks future health risks. But are these pre-existing risks that were going to play out anyway or are they new risks? This study suggests the latter. It used co-sibling data and found that familial factors (genetic and environmental) accounted for only a small

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