Long-Term Stroke Risk Higher for Women With Pregnancy Complications
THURSDAY, July 3, 2025 -- Women who experience five major adverse pregnancy outcomes have a higher long-term stroke risk, according to a study published online June 23 in the European Heart Journal.
Casey Crump, M.D., Ph.D., M.P.H., from the University of Texas Health Science Center in Houston, and colleagues conducted a national cohort study involving 2,201,393 women with a singleton delivery in Sweden during 1973 to 2015 to examine five major adverse pregnancy outcomes and the long-term risk for stroke. The hazard ratios (HRs) for stroke were assessed in association with preterm delivery, small for gestational age, preeclampsia, other hypertensive disorders, and gestational diabetes, adjusting for other maternal factors.
The researchers found that 30 percent of women experienced an adverse pregnancy outcome, and 1.6 percent of women were diagnosed with stroke in 48 million person-years of follow-up. Independent associations were seen for all five adverse pregnancy outcomes with long-term increased risks for stroke. Adjusted HRs for stroke associated with specific adverse pregnancy outcomes were 1.86 for gestational diabetes, 1.82 for other hypertensive disorders, 1.40 for preterm delivery, 1.36 for preeclampsia, and 1.26 for small for gestational age with up to 46 years of follow-up. Even 30 to 46 years after delivery, all HRs remained significantly elevated. Shared familial factors partially explained these findings.
"Both women and their doctors should now recognize that pregnancy complications are an early signal for future stroke risk," Crump said in a statement. "This can help us identify high-risk women long before they suffer a stroke or other cardiovascular disease. Women who experience these complications need support to reduce other cardiovascular risk factors."
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