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Women who've had certain pregnancy complications have significantly higher odds for a stroke than women with uncomplicated pregnancies, new research shows.
Moreover, these strokes may occur at a relatively early age, according to investigators at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles.
Also, compared to women with a single uncomplicated pregnancy, women who experienced complications in two or more pregnancies had twice the risk of stroke before age 45, the study authors noted.
In light of these findings, women and their doctors should talk about a history of pregnancy complications including gestational high blood pressure, preeclampsia or preterm birth, the researchers said.
“We understand from past studies in the U.S. that women have a greater risk of experiencing a stroke and a disproportionate burden of disability after a stroke than men,” said study co-author Dr. Natalie Bello, director of hypertension research in the Smidt Heart Institute.
“This study deepens our understanding of why women may be more greatly impacted by stroke risk and opens the door to more meaningful conversations about pregnancy history among patients and their clinicians,” Bello said in an institute news release.
One in five pregnancies in the United States is affected by an adverse pregnancy outcome, the researchers said in background notes.
A stroke is a medical emergency that happens when blood flow to the brain stops. It can affect your ability to move, speak, eat, drink, swallow and see clearly. A stroke can also impair your ability to think and remember, solve problems or control bodily functions.
Lifestyle interventions such as a healthy diet and increased physical activity may reduce the risk of pregnancy-related complications, Bello said. Evidence also suggests using low-dose aspirin to prevent preeclampsia in women who have a greater risk.
For the study, the researchers used data from a Finnish health registry, including more than 144,000 women who gave birth sometime after 1969.
Among them, nearly 317,000 births were recorded.
The investigators found about 18% had at least one pregnancy with an adverse pregnancy outcome. About 3% of women experienced an adverse pregnancy outcome with two or more pregnancies.
Those who had pregnancy complications tended to have more health issues, such as obesity, high blood pressure, heart disease and migraine.
Among those who had a stroke, the stroke occurred at an earlier age, 52.6 years on average, in women who experienced two or more adverse pregnancy outcomes. This was compared to 54.8 years in women with one adverse pregnancy outcome and 58.3 years in those with uncomplicated pregnancies.
“Most notably, women with recurrent adverse pregnancy outcomes had more than twice the stroke risk before age 45,” Bello said. “This emphasizes the need for women to share their pregnancy history with their doctors, especially if they experience neurologic symptoms concerning for stroke or transient ischemic attack (TIA) that tends to resolve within minutes to hours.” A TIA is often referred to as a mini-stroke.
Bello would like to see a similar, more diverse study done in the United States.
“We also need future research to consider the impact of adding an adverse pregnancy outcome into stroke risk calculators. This may better help us risk stratify women and strategize how to apply prevention strategies like getting cholesterol and blood pressure under control,” she said.
The study results were published May 22 in the journal Stroke.
The U.S. National Institutes of Health has more on pregnancy complications.
SOURCE: Cedars-Sinai Medical Center, news release, May 22, 2023
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