Pregnancy complications increase the risk of stroke in the long term

According to a large cohort study conducted in Sweden, certain pregnancy complications are associated with a significant increase in the risk of stroke for up to several decades after childbirth.The analysis looked at more than 2,201,393 women who gave birth between 1973 and 2015. Among them, 667,774 (30%) experienced pregnancy complications, while 35,824 (1.6%) were diagnosed with stroke during the study period. The study, published in the European Heart Journal, examined five major adverse outcomes: gestational diabetes, preeclampsia, other hypertensive disorders of pregnancy, preterm birth, and low birth weight for gestational age. Each of these complications was associated with an increased risk of stroke.Women who had gestational diabetes and other hypertensive disorders had a 1.86 (95% CI: 1.69–2.04) and 1.82 (1.67–1.98) higher risk of stroke than those who had no complications. The risk of stroke was also significantly higher in women who had given birth prematurely (HR: 1.40; 95% CI: 1.36–1.45), those who had suffered from preeclampsia (HR: 1.36; 95% CI: 1.31–1.41) or who gave birth to a baby with low birth weight for gestational age (HR: 1.26; 95% CI: 1.22–1.29).All risks remained significantly elevated, even 30 to 46 years after giving birth, particularly among women who had suffered from gestational diabetes (HR: 2.5 from 30 to 46 years after giving birth). The study authors emphasized that this complication is strongly associated with a subsequent risk of type 2 diabetes, a risk factor for stroke in women.Obstetric complications as risk factorsThe data were extracted from the Swedish Medical Birth Register and national hospital databases. Statistical analyses were based on Cox models. Two models were used: One adjusted for sociodemographic and medical factors, the other also including other pregnancy complications.These findings are consistent with other studies that have highlighted a link between obstetric complications and cardiovascular disease. “All major adverse pregnancy outcomes should now be recognized as independent long-term risk factors for stroke,” wrote the study authors. “Adverse pregnancy outcomes can enable the early identification of high-risk women well before the onset of stroke, allowing for earlier preventive intervention.”The researchers call for further studies in underrepresented population groups that are often more exposed to pregnancy complications and stroke due to limited access to pre- and postnatal care.

Pregnancy complications increase the risk of stroke in the long term

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