Pre‐eclampsia is a pregnancy‐associated condition with complex disease mechanisms and a risk factor for various long‐term health outcomes for the mother and infant.

To summarise evidence on the association of pre‐eclampsia with long‐term health outcomes arising in women and/or infants.

PubMed, EMBASE, Scopus and ISI Web of Science were searched from inception to July 2020.

Systematic reviews and meta‐analyses examining associations between pre‐eclampsia and long‐term health outcomes in women and their infants.

Data were extracted by two independent reviewers. We re‐estimated the summary effect size by random‐effects and fixed‐effects models, the 95% confidence interval, the 95% prediction interval, the between‐study heterogeneity, any evidence of small‐study effects and excess significance bias.

Twenty‐one articles were included (90 associations). Seventy‐nine associations had nominally statistically significant findings (P < 0.05). Sixty‐five associations had large or very large heterogeneity. Evidence for small‐study effects and excess significance bias was found in seven and two associations, respectively. Nine associations: cerebrovascular disease (cohort studies), cerebrovascular disease (overall), cardiac disease (cohort studies), dyslipidaemia (all studies), risk of death (late‐onset pre‐eclampsia), fatal and non‐fatal ischaemic heart disease, cardiovascular mortality (cohort studies), any diabetes or use of diabetic medication (unadjusted), and attention deficit/hyperactivity disorder (ADHD) (adjusted) were supported with robust evidence.

Many of the meta‐analyses in this research field have caveats casting doubts on their validity. Current evidence suggests an increased risk for women to develop cardiovascular‐related diseases, diabetes and dyslipidaemia after pre‐eclampsia, while offspring exposed to pre‐eclampsia are at higher risk for ADHD.

Cardiovascular and cerebrovascular diseases were supported with convincing evidence for long‐term health outcomes after pre‐eclampsia.