History of Pregnancy Complications and the Risk of Ischemic Stroke in Young Women

Abstract

Background and objectives: Pregnancy complications, such as hypertensive disorders of pregnancy (HDP), small for gestational age (SGA), preterm birth, gestational diabetes, stillbirth, and miscarriage, may increase the risk of ischemic stroke several years later. The aim of this study was to quantify the association between a spectrum of pregnancy complications and (the cause of) ischemic stroke in young women (<50 years).

Methods: This study included 358 women (18-49 years) with first-ever imaging-proven ischemic stroke from the Observational Dutch Young Symptomatic StrokE study and 714 women from the Pregnancy and Infant Development Study, frequency-matched on age at most recent pregnancy and gravidity.

Results: Women with an ischemic stroke at young age (median maternal age = 28 years [IQR = 24-31]) were more likely to have a history of HDP, SGA, preterm birth, gestational diabetes, stillbirth, and miscarriage, compared with women without ischemic stroke (median maternal age = 29 years [IQR = 26-31]). Specifically, the risk of having an ischemic stroke due to (likely) large artery disease, compared with women with a cryptogenic stroke, was increased for women with a history of HDP, SGA, and preterm birth.

Discussion: A history of pregnancy complications may identify women at increased risk of ischemic stroke at young age, in particular atherosclerotic stroke.