Pregnancy Complications Up Later Stroke Risk

Women With Preeclampsia, Other Common Problems Should Pay Close Attention to Diet, Exercise

From the WebMD Archives

Sept. 28, 2005 (San Diego) -- Pregnancy complications are a risk factor for stroke later in life, new research shows.

The findings suggest that women at risk for stroke later in life -- based on specific pregnancy complications -- may benefit from early preventive interventions.

The new study showed that women who experienced pregnancy complications were nearly 75% more likely to have a stroke an average of 13.5 years later than women with uncomplicated pregnancies.

Certain common pregnancy problems such as preeclampsia (high blood pressure during pregnancy) more than double the risk of having a stroke, says researcher Cheryl Bushnell, MD. Bushnell is an assistant professor of neurology at Duke University in Durham, N.C.

Making matters worse, she tells WebMD, is that most of these women have a stroke by the time they turn 40.

The study was presented at the annual meeting of the American Neurological Association.

Preeclampsia is marked by three specific symptoms during pregnancy: water retention (with swelling particularly in the feet, legs, and hands); high blood pressure; and protein in the urine, a sign of possible kidney damage. All three must be present at the same time.

The condition prevents the placenta from receiving enough blood, which can cause your baby to be born very small. It is also one of the leading causes of premature birth. Premature infants have an increased risk of death.

The only real cure is the birth of the baby. "And at that point, we used to think, that's that," Bushnell says. "The problem has resolved."

Early Signals Not to Ignore

What the new findings suggest, she says, is that preeclampsia or other pregnancy complications may be the first sign of cardiovascular disease.

"This may be a signal to these women that they are at higher-than-average risk for stroke or heart attack later in life," Bushnell says.

"Women who have pregnancy complications should pay special attention to things like weight loss and exercise -- all the things we generally recommend to prevent heart disease and stroke."

Also, many of these women have cholesterol levels "that are way out of whack. Their cholesterol should be tested, and if needed, treated with cholesterol-lowering drugs such as statins."

Heavy Bleeding During Birth Also a Major Risk

The study included 162 women who had a stroke more than six weeks after giving birth and 306 women who did not have a stroke after pregnancy. The women were an average of 26 to 27 years old when they gave birth.

The researchers then looked to see how many of the women in each group had the following pregnancy complications: abruption, in which the lining of the placental wall is damaged and bleeds and the women need to be put on complete bed rest until they give birth; preeclampsia; postpartum hemorrhage, in which is there is a large loss of blood at the time of delivery; or pregnancy-related diabetes.

Women who gave birth to low- or high-birth-weight babies, had a stillbirth, or gave birth prematurely were also considered to have complications.

By an average of 13.5 years later, women who had any of these complications were 74% more likely to have had a stroke than those who had uncomplicated pregnancies.

Women with preeclampsia were more than twice as likely to have a stroke as those who did not have the condition, and those who had pregnancy-related diabetes were almost two and a half times more likely to have a stroke.

Heavy bleeding at the time of birth increased a woman's risk of stroke almost tenfold, "but the numbers were small; we need further study for confirmation," Bushnell says.

Bart Demaerschalk, MD, assistant professor of neurology at the Mayo Clinic in Scottsdale, Ariz., says the findings draw attention to an important and often overlooked problem.

"The study was well done and certainly establishes as association between pregnancy complications and stroke risk later in life," he tells WebMD. "If women have any of these complications, they should be closely monitored."

Show Sources

SOURCES: American Neurological Association 130th Annual Meeting, San Diego, Sept. 25-28, 2005. Cheryl Bushnell, MD, assistant professor of neurology, Duke University, Durham, N.C. Bart Demaerschalk, MD, assistant professor of neurology, Mayo Clinic, Scottsdale, Ariz.

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