Stroke in Pregnancy: An Emerging Health Problem

Women who delay pregnancy until a later age are placing themselves at increased risk of stroke, according to Dr. Matthew Fink, Professor of Clinical Neurology and Interim Chairman and Neurologist-in-Chief of the Department of Neurology and Neuroscience at Weill Cornell Medical College in New York.

Speaking at the monthly community health seminar, Medicine & U moderated by Professor Basim M. Uthman at the Weill Cornell Medical College in Doha, Dr. Fink said the increasing prevalence of hypertension, cardiac disease, obesity and diabetes also adds to the risk of stroke for mothers.

Current medical research indicates that there is also a high prevalence of diabetes, obesity and hypertension among women in Qatar and the Middle East, making this an important issue for expectant mothers in the region. The prevalence of obesity and hypertension suggests that cardiovascular disease will be a major health problem in the Middle East.

In the U.S., the incidence of pregnancy-associated stroke has increased dramatically over the past 15 years and a recent national study in the United States reported that rates of stroke in women during pregnancy, or soon after giving birth, have jumped an average of 54 percent in the past 12 years.

There is a greater risk of stroke for pregnant women due to a higher volume of blood in the body and also because of increased risk of high blood pressure, blood clots and migraine headaches. According to doctors, hormones and blood pressure fluctuate wildly in the weeks after giving birth, which may increase risk during that time.

Brain hemorrhages and cerebral venous thrombosis or bleeding on the brain predominate rather than ischemic stroke, which is the most common type in the elderly. An ischemic stroke occurs when an artery supplying the brain with blood becomes blocked, suddenly decreasing or stopping blood flow and ultimately causing a brain hemorrhage.

Dr. Fink said stroke prevention should focus on risk factor reduction, particularly hypertension, and older women should seek excellent prenatal care. Practical lifestyle changes including weight reduction, regular exercise, a healthy diet and less salt in the diet can help to lower high blood pressure. In vitro fertilization also raises a host of new questions and potential problems that require study, especially in older women, Dr. Fink said.