From gestational diabetes to preeclampsia, pregnancy complications may be associated with a woman’s risk of early death — even decades later.

“Adverse pregnancy outcomes may lead to small physiologic changes that are initially hard to detect, such as inflammation or other abnormalities in small blood vessels,” Dr. Casey Crump, a UTHealth Houston professor and author of recent study published in JAMA Internal Medicine, told CNN. “These changes may persist or progress after pregnancy, eventually leading to other health problems that may take years or even decades to appear.”

Researchers from the University of Texas Health Science Center and Sweden’s Lund University analyzed data from more than 2 million women who had given birth in Sweden from 1973 to 2015. According to the study, roughly 30% of women experience complications during pregnancy.

“Pregnancy provides a key opportunity to identify high-risk women and start interventions earlier in life, before other health problems develop,” Crump said. “Women who experience adverse pregnancy outcomes need close follow-up with their primary care doctor, starting soon after delivery, for regular preventive care to help reduce these risks and protect their long-term health.”

The researchers focused on five major pregnancy complications for the study: gestational diabetes, preterm delivery, infants with low birth weights, preeclampsia and high blood pressure disorders. They then observed how long each woman lived.

More than 88,000 women featured in the study died, and all five of the aforementioned complications were associated with a risk of early death.

“It is not so much that pregnancy causes or directly increases the risk of these long term complications,” Dr. Ashley Roman, NYU Langone Health’s vice chair for clinical affairs and chief of obstetrics, told CNN. “The way I explain this to my patients is that pregnancy is a stress test that can unearth a predisposition to certain diseases later in life. A pregnancy is supported by the placenta, which creates hormones and needs a rich blood supply to do its job right. How the mother’s body responds to these hormones and vasculature created by the placenta is an early window to health in later life.”