Women who experience adverse pregnancy outcomes (APO) are known to have an increased risk of developing chronic hypertension later in life. Psychological factors such as perceived stress during and after pregnancy may be associated with later blood pressure outcomes..

A prospective cohort analysis published in Hypertension used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health (nuMoM2b-HHS) Study. Participants were women enrolled during their first pregnancy and followed for cardiovascular outcomes after delivery. Perceived stress was assessed using the Perceived Stress Scale during the first and third trimesters and again 2 to 7 years postpartum. Latent class trajectory analysis identified subgroups with similar stress patterns over time. APOs were abstracted from medical records and included hypertensive disorders of pregnancy, preterm birth, small-for-gestational-age birth, and stillbirth. Multivariable regression models evaluated associations between stress trajectories, blood pressure levels, and incident hypertension during follow-up.

Three distinct stress trajectory groups were identified: persistently low, moderate, and high stress. After adjustment for covariates, the stress trajectory group was not associated with systolic or diastolic blood pressure or with incident hypertension. However, a significant interaction between stress trajectory group and APO status was observed (P for interaction = 0.04). Higher stress trajectories were associated with higher blood pressure among women with APO (β = 1.991±0.819 mm Hg; P = 0.02), whereas no association was observed among women without APO.

Perceived stress alone was not associated with later hypertension after pregnancy. However, higher perceived stress was associated with higher blood pressure among women who experienced APOs.