Long-term mortality in women with a history of hypertensive disorders of pregnancy: a systematic review and meta-analysis.

Background: Hypertensive disorders of pregnancy (HDP) are associated with adverse long-term maternal health outcomes, yet comprehensive evidence quantifying their impact on all-cause and cause-specific mortality, particularly among women with preeclampsia/eclampsia (PE/E) and gestational hypertension (GH), remains limited. Hence, we conducted a systematic review and meta-analysis to quantify the risks of all-cause and cause-specific mortality in women with a history of HDP. Methods: This study was conducted as a systematic review and meta-analysis. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2024 and updated on 31 January 2026. Observational studies examining the association between HDP (particularly GH and PE/E) and subsequent all-cause mortality or disease-specific mortality were included. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using I Findings: 53 studies were included in the systematic review, and 29 non-duplicated datasets comprising 14,221,347 individuals were included in the meta-analysis. A history of HDP was related to a 45% increased risk of all-cause mortality (RR = 1.45, 95% CI = 1.30-1.61; I Interpretation: Women with a history of HDP, particularly PE/E, have a higher risk of all-cause mortality and cause-specific mortality. These findings highlight the importance of lifelong health monitoring in this population. Future studies should focus on recommended postpartum management protocols and long-term lifestyle intervention strategies to reduce long-term risks. Funding: Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project and National High-Level Hospital Clinical Research Funding.