Women who have experienced certain pregnancy complications may face an increased risk of stroke later in life, according to a study by UTHealth Houston. The research, led by Casey Crump, MD, PhD, MPH, and published in the European Heart Journal, examined 2.2 million women with singleton deliveries in Sweden from 1973 to 2015.
The study identified five common pregnancy complications associated with a higher risk of stroke: gestational diabetes, preeclampsia, other hypertensive disorders, preterm delivery, and having babies small for gestational age. Follow-up data for stroke incidence was collected over 46 years until 2018. Among the participants, 30% experienced an adverse pregnancy outcome and 1.6% were diagnosed with a stroke.
According to the American Stroke Association (ASA), stroke is the third leading cause of death among women and claims more female lives than male. The study found that women with high blood pressure or diabetes during pregnancy had nearly double the risk of stroke. Preterm delivery increased the risk by 40%, while preeclampsia raised it by 36%. Babies born small for their gestational age resulted in a 26% increase in risk.
Crump emphasized the importance of medical care before conception and during pregnancy to prevent these outcomes. "Good medical care before conception and during pregnancy is crucial for helping to prevent these adverse pregnancy outcomes," said Crump. He also highlighted the need for early intervention when such complications are observed during pregnancy.
Women at higher risk should avoid tobacco use and manage their blood pressure, cholesterol, and blood sugar levels. Maintaining a healthy weight and engaging in regular physical activity can further reduce stroke risk. Regular physician appointments are vital for ongoing health management.
Crump noted that many women who experience adverse pregnancies are not adequately monitored afterward due to lack of awareness about their increased stroke risk. "Many women who have adverse pregnancies are lost to follow-up," he said.
He recommended transitioning women quickly from obstetric to primary care for long-term prevention strategies against cardiovascular diseases. "These complications should be recognized as long term risk factors for stroke," Crump added.
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