Closer Follow-up of Preeclampsia in Pregnancy Needed to Reduce Risk of Stroke

Paying attention to modifiable risk factors and screening for bleeding disorders and blood clots may aid prevention efforts, researchers say.

Stroke in women who develop preeclampsia during pregnancy is relatively rare, but hypertension, urinary tract infections, and clotting abnormalities all significantly increase risk, new data suggest. The majority of strokes that occur are in the postpartum period, researchers found, indicating the need to be more vigilant of a mother’s health after birth.

“Women who have preeclampsia have about six times the risk of stroke during pregnancy and postpartum compared to pregnant women who don’t have preeclampsia,” said lead author Eliza C. Miller, MD (New York-Presbyterian Hospital/Columbia University Medical Center, NY), in an interview with TCTMD. “When women with preeclampsia have a stroke, their strokes are severe. In this cohort, more than one in 10 died. Even if they survive the stroke, many of them have long-term disabilities.”

Nearly half of the strokes were hemorrhagic, and two-thirds occurred postpartum.

Navigating a ‘Vulnerable Time’

“That postpartum period is really a vulnerable time for women,” Miller observed. “They are not getting the kind of medical attention that they got during their pregnancy; they just had a baby and there is so much else going on in their lives. Many times they don’t come back for their follow-up, either because they’re not given an appointment or they don’t call for an appointment,” she said. “We cannot let these women just fall off the radar.”

The study, published today in Stroke, examined data from 2003 through 2012 on more than 3 million women in the New York State Department of Health inpatient database who were admitted to a hospital for any reason. Of these, 88,857 had preeclampsia and 197 (0.2%) had pregnancy-associated stroke, resulting in an incidence of stroke in the preeclampsia population of 222 in 100,000.

We cannot let these women…

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