Risk of Stroke Increased Significantly in Women With Pre-eclampsia

Infections, hypertension, bleeding disorders, and clot-forming conditions increase stroke risk during and after childbirth.

Highlights

Pre-eclampsia or newly elevated blood pressure during pregnancy develops in about 3 to 8 percent of all pregnant women.
Pre-eclampsia can be mild and symptomless, but it can quickly become severe and can have serious consequences for both mother and fetus.
The risk of stroke during pregnancy and postpartum is greater if they have urinary tract infections, chronic high blood pressure, or clotting or bleeding disorders.

About two-thirds of pre-eclampsia-related strokes occur after birth, when the mother has gone home. With all the stress of having a new baby, mothers sometimes ignore symptoms like headaches that could be a sign of a serious problem.

Pre-eclampsia--newly elevated blood pressure during pregnancy--develops in about 3 to 8 percent of all pregnant women, according to the researchers. The cause of pre-eclampsia is not well understood. While preeclampsia can be mild and symptomless, it can quickly become severe.

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‘Women with pre-eclampsia who had chronic hypertension, bleeding or clotting disorders, or infections--particularly urinary tract infections--appeared to be at significantly increased risk of stroke.’

Recently Discovered Dangers of Pre eclampsia

Severe pre-eclampsia can have serious consequences for both mother and fetus. One of the most dangerous complications is pregnancy-associated stroke, which occurs up to 6 times as often in women with pre-eclampsia compared with pregnant women overall.

Women with pre-eclampsia face a heightened risk of stroke during pregnancy and postpartum if they have urinary tract infections, chronic high blood pressure, or clotting or bleeding disorders, according to a study by Columbia University Medical Center (CUMC) and NewYork-Presbyterian researchers.

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"We have suspected that certain conditions raise the risk of stroke in women with preeclampsia, but few studies have taken a rigorous look at this issue," said lead author Eliza C. Miller, MD, a postdoctoral vascular neurology fellow in the department of neurology at NewYork-Presbyterian/Columbia University Medical Center.

"Since strokes can be so devastating, it is critical to know whether these are just random events or due to modifiable risk factors."

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Pre-eclampsia-Related Stroke

In the study, Dr. Miller and her colleagues analyzed the health records of 197 women who had a pre-eclampsia-related stroke and 591 women with preeclampsia who did not have a stroke, according to the New York State Department of Health inpatient database.

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The incidence of stroke in women with pre-eclampsia was over 200 per 100,000 deliveries, and more than one in 10 women in the study who had a pre-eclampsia-related stroke died in the hospital.

Women with pre-eclampsia who had chronic hypertension, bleeding or clotting disorders, or infections--particularly urinary tract infections--appeared to be at significantly increased risk of stroke.

Infections cause inflammation, which is known to play an important role in triggering stroke, especially in young people. Pre-eclampsia itself is an inflammatory disorder and infections may trigger women over the edge.

Monitoring Women After Child Birth

"The take-home message for pregnant women with preeclampsia and their doctors is to pay close attention to these risk factors, as well as to warning signs for stroke," said Dr. Miller.

"It's important to note that the risk of stroke in women with preeclampsia doesn't end with delivery, as is commonly thought. They think, 'I'm tired, I just had a baby--of course, I have a headache.' But this is not something to take lightly. Call your doctor if you have any signs and symptoms of stroke."

Reference

Eliza C. Miller et al., Stroke risk factors for pregnant women with preeclampsia uncovered, Stroke (2017).

Source-Medindia