New research has shown that women with two or more pregnancies impacted by an adverse pregnancy outcome have an increased risk of stroke.
The investigators from the Smidt Heart Institute discovered that women who experience an adverse pregnancy outcome, such as gestational hypertension, preeclampsia or preterm birth, have a higher risk of developing stroke in their lifetime.
Senior author of the study, Natalie Bello MD, says: “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.
“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.”
In order to reduce the risk of pregnancy-related complications, Bello says recent research suggests that lifestyle interventions such as a healthy diet and increased physical activity can help.
There is also robust evidence for the use of low-dose aspirin to precent preeclampsia in those at an increased risk.
Investigators on this study analysed data from 144,306 women from the FinnGen Study, which is a public/private partnership of Finnish health registry data. This cohort included women who gave birth after 1969 when the hospital discharge registry was established.
Of these women, a total number of 316,789 births were recorded.
Key findings included:
- 7.9 per cent had at least one pregnancy with an adverse pregnancy outcome, and 2.9 per cent of women experienced an adverse pregnancy outcome with two or more pregnancies.
- Women with adverse pregnancy outcomes had more medical comorbidities, including obesity, hypertension, heart disease and migraine.
- Of women in this study 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, compared with 54.8 years in women with one adverse pregnancy outcome, and 58.3 years in women who had uncomplicated pregnancies.
Bello, says: “Most notably, women with recurrent adverse pregnancy outcomes had more than twice the stroke risk before age 45.
“This emphasises 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.”
Adding to this, Bello hopes for further research in a group of women with greater diversity in race and ethnicity, she says: “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 strategise how to apply prevention strategies like getting cholesterol and blood pressure under control.”
