EDITOR —Sattar and Greer discuss the probability that complications in pregnancy may predispose women to vascular and metabolic disease in later life.1 The link between pregnancy complications and coronary heart disease remains unexplained. We believe that during pregnancy the hormonal and other stresses provoke cardiovascular and metabolic abnormalities in susceptible individuals, which may recur and become permanent as the patient ages. Many of these are coronary risk factors; disturbances in glucose metabolism, which underlie the development of gestational diabetes, are a good example.