Preeclampsia: A Risk Factor for Stroke

Preeclampsia is risk factor for stroke during pregnancy and after birth. Learn how to avoid a stroke by knowing how to control risk factors.

If you are expecting and all is going well by the mid-point of your pregnancy, you may be surprised to find out you have preeclampsia during the 20^th week or later. This not uncommon complication of pregnancy, marked by newly elevated blood pressure, develops in about three to eight percent of all pregnant women, according to researchers at New York-Presbyterian/Columbia University Medical Center.

While preeclampsia may be mild and even symptom-free in some women, the condition can be severe and, untreated, may damage the health of a mom-to-be and, because preeclampsia may cause premature birth, her unborn child.

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One of the most dangerous and even life-threatening risks of preeclampsia is stroke. In fact, women with preeclampsia suffer strokes six times more often than pregnant women without the condition. However, factors linking preeclampsia to stroke have been uncovered, offering hope many pregnancy-triggered strokes can be prevented.

"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 New York-Presbyterian/Columbia University Medical Center neurologist Eliza C. Miller, MD. "Since strokes can be so devastating, it is critical to know whether these are just random events or due to modifiable risk factors."

To find out, Miller and her colleagues looked at New York State Department of Health records and found the incidence of stroke in women with preeclampsia was more than 200 per 100,000 deliveries. The research team analyzed the health records of 197 women who had a preeclampsia-related stroke and 591 women with preeclampsia who did not suffer a stroke.

The results of the study, published in the journal Stroke, showed one in 10 women who had a preeclampsia-associated stroke died in the hospital. The findings also revealed the women with preeclampsia who suffered strokes had other existing health problems. That suggests recognizing and treating those additional conditions may help prevent strokes.

"Women with preeclampsia who had chronic hypertension, bleeding or clotting disorders, or infections — particularly urinary tract infections — appeared to be at significantly increased risk of stroke," Miller said.

Whether infection played any role in triggering stroke in pregnant women with preeclampsia was what Miller called “the biggest question mark going into the study.” She noted infections cause inflammation, which is known to play a role in triggering strokes, especially in young people — so the finding wasn’t a total surprise.

“Preeclampsia itself is an inflammatory disorder. Infections may be what pushed some of these women over the edge," Miller explained. “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.”

If you have a disorder that causes blood clots or excessive bleeding, make sure you take any prescribed medication and follow all instructions from your doctor. Report any signs and symptoms of a urinary tract infection to your healthcare provider ASAP, too.

The American Heart Association advises  everyone with hypertension, including pregnant women, to check their own blood pressure daily with a monitor at home. If your numbers rise, talk to your doctor about how you can lower your blood pressure safely while pregnant with regular exercise (if your doctor says it is safe for you) and a healthy diet.

Getting pregnancy high blood pressure under control, especially if you have preeclampsia, can not only help prevent a stroke now but in the future, too.

"It's important to note that the risk of stroke in women with preeclampsia doesn't end with delivery, as is commonly thought," Miller said. “About two-thirds of preeclampsia-related strokes occur after birth, when the mother has gone home.”

She adds it’s not unusual for women taking care of newborns to assume any new health symptoms are due to lack of sleep and stress. But that can be a dangerous mistake. For example, a sudden headache can be a sign of a stroke.

“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,” Miller said.

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