The researchers examined the medical records of all women who had given birth at Duke University Hospital in North Carolina between 1979 and 2005, and undergone cardiac catheterisation since 1969.
They looked for any association between complications of pregnancy, and CVD or mortality. Complications included pre-eclampsia, gestational diabetes, in utero death, small and large for gestational age, postpartum haemorrhage, stillbirth, premature birth or twins.
They found that women with pregnancy complications had higher rates of hypertension, diabetes and smoking during pregnancy, but even after correcting for these factors, complications during pregnancy were associated with a 60 per cent increased risk of later diagnosis of CVD.
Women who had pregnancy complications were also found to have double the all-cause mortality rate of women who gave birth without complications.
Dr Mimi Biswas, a cardiologist at Duke University, North Carolina, said: 'Complications during pregnancy can be seen as novel early warning signs of future heart disease or mortality risk. Younger women tend not to be followed for CVD. Based on the results of our analyses, those women with difficult pregnancies should be.'
In a separate analysis, Dr Biswas and colleagues found that after correcting for other factors, smoking during pregnancy almost tripled the mother's risk of cardiac death and almost doubled her risk of developing coronary artery disease.