Stroke is not a common occurrence in younger patients, but the risk of stroke is tripled in pregnant and postpartum women. The teams in NewYork-Presbyterian's Comprehensive Stroke Centers, collaborating with the hospital's renowned ob-gyn and maternal-fetal medicine physicians, work to minimize the chance of a stroke in pregnant women at risk and have the expertise and knowledge to treat it promptly and effectively should a stroke arise.
Who is at risk for stroke during pregnancy?
About half of pregnancy-related strokes involve bleeding in the brain (hemorrhagic stroke), and the remainder are due to a blood clot (ischemic stroke). The risk of a stroke is greatest during the two weeks following childbirth and may remain elevated for 12 or more weeks after delivery. Strokes happen in 30 out of every 100,000 deliveries and are most common (as high as 1 out of 500 births) in women who develop preeclampsia — newly elevated blood pressure during pregnancy. Women with these other risk factors may also have a higher risk of stroke related to pregnancy:
- Migraine headaches
- Vascular conditions
- Chronic kidney disease
- Hypertension (high blood pressure) diagnosed before pregnancy
- Gestational diabetes, which raises the risk of high blood pressure during pregnancy and for heart disease and stroke later in life
Call 9-1-1 immediately if you are experiencing any of these sudden stroke symptoms:
- Balance or coordination problems
- Loss of vision in one or both eyes
- One side of the face drooping or feeling numb
- Inability to life both arms
- Slurred speech
Contrary to popular belief, older age does not in and of itself raise the risk of stroke during pregnancy. Columbia University investigators showed that stroke risk in older pregnant women is similar to women of the same age who aren't pregnant. However, one in five strokes in women under 35 were related to pregnancy.
How being pregnant may raise stroke risk
Pregnancy is like a stress test: it can strain the heart and blood vessels. Changing hormones also play a role. Other factors may include:
Inflammation. Preeclampsia is characterized by inflammation, which can trigger a stroke. Columbia University investigators showed that women with preeclampsia face a heightened risk of stroke during and after pregnancy if they had urinary tract infections, chronic high blood pressure, or clotting or bleeding disorders.
Blood clots. Weill Cornell Medicine researchers reported that some mothers remain at risk of developing a serious blood clot for 12 weeks after giving birth, particularly during the first six weeks. Clots can develop in pregnant women because their blood is more likely to clot to prevent excessive blood loss during labor and childbirth. While the overall risk is low, women at risk of blood clots may take blood thinners during the postpartum weeks.
Pay attention to these symptoms during and after childbirth
The best way to prevent a stroke during pregnancy is to make sure you continue to see your doctor for prenatal and postpartum visits and report any recurrent headaches. Your doctor will also monitor your blood pressure and prescribe specialized care if you have preeclampsia. If you recently had a baby, tell your doctor if you are having headaches that are not getting better over time.
Why choose us
The obstetric and stroke care teams at NewYork-Presbyterian know how to recognize and manage pregnancy-related stroke and its risk factors. Our maternal-fetal medicine experts have cared for women with the highest-risk, most complex pregnancies and can customize a plan of care to minimize the risk of stroke. If a stroke does occur, the neurologists and neuro-interventionalists in our Neuro-ICUs respond quickly and effectively to stabilize each patient and promote recovery. We even have dedicated neuro-obstetric teams which unite these specialists to achieve the best outcomes possible.