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Pregnancy-Related Strokes Jump 54 Percent

THURSDAY July 28, 2011 -- The risk of suffering a stroke during -- or soon after -- pregnancy has increased dramatically in recent years, according to new U.S. government research.

From the mid-1990s to 2006-2007, the rate of pregnancy-related stroke hospitalizations went up by 54 percent.

"When we started this study, we expected to see some increase in pregnancy-related stroke, but we did not expect to see such a big increase," said study author Dr. Elena Kuklina, an epidemiologist in the division for heart disease and stroke prevention at the U.S. Centers for Disease Control and Prevention in Atlanta.

But, pregnancy-related stroke is still "pretty rare," she added. About 4,000 strokes a year occurred at the start of the study, compared to more than 6,000 at the end.

Results of the study, published online July 28, will appear in the September print edition of the journal Stroke.

The study wasn't designed to assess what factors influenced the increased risk of stroke, Kuklina said. But, women today are often older when they get pregnant, and they may be overweight or obese, which are known risk factors for stroke, she noted.

Also, more women who become pregnant have pre-existing chronic medical conditions, such as congenital heart disease, high blood pressure, diabetes and autoimmune diseases, she said. In the past, many of these women would have been discouraged from attempting pregnancy.

Data for the study came from a national database that gathers discharge information from 1,000 hospitals.

The rate of hospitalization for stroke during pregnancy went up 47 percent from 1994-95 to 2006-2007, according to the study. In the postpartum period (after the birth of the baby), the rate of stroke hospitalizations jumped even more -- 83 percent -- during the same time period. Rates of stroke hospitalizations remained the same during delivery.

Nearly one-third of the women who had a stroke during pregnancy, and more than half who had a stroke during the postpartum period, had high blood pressure or a history of heart disease, the study found.

Women between the ages of 25 and 34 were hospitalized for stroke more often than younger or older women.

Kuklina said that all women should try to be as healthy as possible before they get pregnant, and "try to stick to a healthy lifestyle during pregnancy." She recommended healthful eating, regular physical activity and not smoking.

She also advised women who have a chronic condition to make sure it is as well-controlled as it can be prior to conception. In some cases, she said, doctors might recommend blood-thinning medication to help prevent stroke.

Dr. Mary Rosser, an obstetrician at Montefiore Medical Center in New York City, said she was happy to see a study drawing attention to this issue.

"This is a very telling article that will raise awareness. Women might brush off some of the symptoms [of stroke], and just think they're exhausted because they're pregnant or just had a baby," she said.

Some of the symptoms that signal a need for immediate medical attention, Rosser said, include:

  • Sudden confusion, or trouble speaking or understanding others
  • Sudden weakness or numbness in the face, arms or legs, especially if this occurs only on one side
  • Sudden trouble seeing in one or both eyes
  • Trouble walking or coordinating movements
  • Sudden severe headache with no known cause

Rosser said some of the signs that a woman may be developing dangerously high blood pressure during pregnancy include:

  • Headache
  • Swelling in the face or hands
  • Visual changes
  • Pain in the upper right abdomen

These symptoms are of more concern when one or more occur at the same time, she said. She tells her patients to take acetaminophen (Tylenol) for a headache, but if pain persists after 30 minutes to call the doctor. If you already have a known history of high blood pressure, she said that experiencing any of the symptoms listed should prompt a phone call to the doctor.

Women who have chronic conditions at the start of pregnancy should consider seeing a high-risk obstetrician who may be more experienced in handling such conditions, Rosser added.

More information

Learn more about stroke from the U.S. National Library of Medicine.

Posted: July 2011


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