Though pregnancy is a time of joy and anticipation, it also brings some unexpected challenges. The complications in pregnancy are a growing concern, not only because of their immediate risks, but also for what they could bring decades later. A recent study has found that pregnancy complications may do more than just pose short-term risks. A new study published Tuesday in the European Heart Journal suggests that women who experience complications during pregnancy face a higher risk of stroke later in their lives.
What is a stroke
A stroke happens when a blood clot or broken vessel prevents blood from getting to your brain. This can be fatal and needs immediate treatment. Strokes are the second leading cause of death worldwide. Strokes can be life-threatening and even fatal.
Pregnancy complications and stroke
The study, which looked at data from 2.2 million women across 40 years, found that those who had diabetes, high blood pressure during pregnancy, delivered early, or had a low birth weight baby faced a higher risk of stroke later in life. They also said that these common pregnancy complications may be early warning signs of cardiovascular problems in the future.“We know that pregnancy is a ‘natural stress test’ that may reveal higher cardiovascular disease risks long before cardiovascular disease actually develops. Up to one-third of all pregnancies are affected by one of these complications. However, the long-term cardiovascular risks for these women remain poorly understood and so are often not considered in their routine clinical care,” Professor Casey Crump, who led the research, from the Department of Family & Community Medicine at UTHealth Houston, USA, said in a statement.
The study
The researchers collected data from 2.2 million single-baby pregnancies in Sweden between 1973 and 2015. About 30% of the women had at least one complication, such as preterm birth (before 37 weeks), having a very small baby, high blood pressure during pregnancy (including preeclampsia), or pregnancy-related diabetes. The team also gathered the data on women who experienced a stroke in the following years until 2018. The researchers then compared the rates of stroke in women with pregnancy complications and women who did not. FindingsThe results of the study were shocking. They found that the risk of stroke was almost double in women who had high blood pressure (not preeclampsia) or high blood sugar during pregnancy. In women who had a preterm delivery, the risk was around 40% higher, for women with preeclampsia, it was around 36% higher, and for those whose babies were born small for their gestational age, the risk was around 26% higher. The risks were even greater in women who experienced two or more of these complications. The risk of stroke was highest during the first 10 years after childbirth but remained elevated even 30 to 46 years later. In women with pregnancy-related diabetes, the risk continued to rise as time went on.
What are the experts saying
“To our knowledge, this study is the largest ever to examine multiple pregnancy complications in relation to long-term stroke risks in the same cohort of women. Also, it is the first to assess whether families might share factors that predispose both to adverse pregnancy outcomes and stroke, but shared familial factors did not appear to explain our findings. These pregnancy complications share some common features, including placental abnormalities and inflammation, that may potentially affect the structure or function of small blood vessels. Those changes in the small blood vessels sometimes progress further after pregnancy, and this could be one factor in the women’s higher risk of stroke,” Professor Crump said.
“Both women and their doctors should now recognise that pregnancy complications are an early signal for future stroke risk. This can help us identify high-risk women long before they suffer a stroke or other cardiovascular disease. Women who experience these complications need support to reduce other cardiovascular risk factors, including obesity, physical inactivity, unhealthy diet, smoking, high blood pressure, diabetes, and high cholesterol. These interventions should be implemented as early as possible, followed by long-term monitoring to reduce their stroke risk across the life course,” Prof. Crump added. “Stroke is a major cause of death and disability that may be preceded by distinct risk factors in women vs. men. Understanding earlier life, sex-specific stroke risk factors can help identify high-risk individuals who can be targeted for preventive intervention,” Dr Abbi Lane from the University of Michigan, USA, said in an accompanying editorial.
