Pregnancy stress risks
Photo illustration by Jeffrey C. Chase | Photo by Ashley Barnas Larrimore June 03, 2026
UD study links pregnancy stress to long-term cardiovascular effects
Pregnancy is often described as a rollercoaster of emotions, with expectant mothers feeling blissful and joyous while simultaneously anxious and stressed.
But new research from the University of Delaware suggests the effects of that stress may extend far beyond delivery — and impact long-term cardiovascular health.
Women who reported higher stress levels during and after pregnancy were significantly more likely to develop elevated blood pressure years later. Higher stress trajectories over time were also more common among women who experienced pregnancy complications such as pre-eclampsia, pre-term birth and stillbirth.
The study, by Virginia Nuckols, a postdoctoral researcher in the Department of Kinesiology and Applied Physiology (KAAP) within the College of Health Sciences (CHS), was recently published in the journal Hypertension. The research was co-authored by Megan Wenner, associate professor of KAAP; Jody Greaney, assistant professor of health behavior and nutrition sciences; and Freda Patterson, professor and associate dean of research for CHS.
Nuckols said the findings challenge long-standing assumptions about pregnancy-related cardiovascular changes.
“The old dogma that pregnancy complications are isolated events with no lasting consequences has been disproven,” said Nuckols. “Vascular dysfunction that’s present during pregnancy doesn’t just simply go away; it persists after pregnancy and perhaps makes women more susceptible to the effects of stress.”
Nuckols’ research also demonstrates the importance of stress reduction during and after pregnancy for long-term cardiovascular health and was highlighted in an American Heart Association spotlight.
The study, involving more than 3,000 women experiencing their first pregnancy, followed them for two to seven years after pregnancy, tracking blood pressure and self-reported stress levels. Women with hypertension before pregnancy were excluded.
“We wanted to be beyond that ‘fourth trimester’ window but still early enough in their postpartum trajectory to intervene, whether that’s through medication or lifestyle changes,” explained Nuckols.
Researchers did not identify specific stressors, though in future work, Nuckols aims to better understand the stressors this population is experiencing, their assessment of stress and their response.
Understanding these stressors and their impact on mood behavior, and sleep quality could help design stress-reduction interventions that better meet this population’s unique needs.
“We aren’t quite at the stage where stress is measured as a clinical signal,” said Nuckols. “There is more work to do on how we capture and define stress in a fast-paced clinical setting, how stress is managed, and identifying what clinical recommendations, referrals or resources would be most effective.”
She’s also investigating stress and social determinants of health.
“We were not surprised to see that women with the highest stress levels were less likely to have private health insurance and had lower household income levels,” said Nuckols. “These structural factors impact stress, and in turn, cardiovascular health.”
Nuckols appreciates the lifespan perspective approach taken in the Women’s Cardiovascular Research Lab, led by Wenner. Nuckols aims to determine whether addressing stress during pregnancy has a long-term ripple effect later in the lifespan, and calls pregnancy an important opportunity to address stress.
“Pregnancy and the postpartum period are times when women typically have increased interactions with healthcare providers,” she explained. “It’s also a time when women are motivated to improve their health to improve their pregnancy and their baby’s health, so this serves as a unique window to promote stress reduction opportunities.”
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