Stroke During Pregnancy or Postpartum Linked to Higher Cardiovascular, Neuropsychiatric Risks

Women who experience an ischemic stroke during pregnancy or within 3 months postpartum face higher risks of subsequent cardiovascular disease, recurrent stroke, and depression later in life, as well as lower employment rates, according to a population-based study published in Neurology.

In the study, investigators used Finnish nationwide health care registries to identify 97 women who had an ischemic stroke during pregnancy or the postpartum period and matched them with 280 women of similar age who did not experience stroke. Participants were monitored through medical and administrative records for a mean of 12 years. Outcomes assessed included major cardiovascular events, cardiac disease, depression, and employment status. Analyses were adjusted for age, and the study focused on associations rather than causation.

Key findings from the study include the following:

• Among women with pregnancy-associated stroke, 6% experienced a second stroke and 7% had a major cardiovascular event compared with 0% in the control group.
• Cardiac disease occurred in 9% of women with stroke vs 1% of those without stroke, corresponding to nearly 9-times higher odds after age adjustment.
• Depression was diagnosed in 19% of women with stroke compared with 6% of controls, representing nearly 4-times higher adjusted odds.
• Employment declined over time in the stroke group, with 66% employed at the end of follow-up compared with 78% of women without stroke.
• After adjustment for age, women with pregnancy-associated stroke had 45% lower odds of being employed and nearly 5-times higher odds of being retired at study end.
• Despite these outcomes, 92% of women with stroke had good functional status, defined as full recovery or ability to manage most daily activities.

The authors note that the rarity of pregnancy-associated stroke limited sample size and that results may not be generalizable beyond similar health care settings.

Source: American Academy of Neurology. Stroke during pregnancy, postpartum associated with more illness, job status later. American Academy of Neurology. Published January 21, 2025. Accessed January 20, 2025.