Pregnancy Complications May Increase Stroke Risk
Many women encounter complications during pregnancy. Two of the most common ones, elevated blood sugars (gestational diabetes) and elevated blood pressure (preeclampsia) have emerged as possible indicators of increased risk of stroke.
Elevated Blood Sugars (Gestational Diabetes)
Gestational Diabetes is the inability of the body to process carbohydrates during pregnancy. Often there are no symptoms of the condition. It is recommended that all pregnant women be screened for gestational diabetes during their pregnancy.
The symptoms are usually mild and not life-threatening to the pregnant woman. However, the increased blood sugar levels in the mother are associated with an increased rate of complications in the baby, including:
- Large size at birth
- Birth trauma, especially of the shoulders
- Hypoglycemia (low blood sugar)
- Jaundice (yellowing of the skin)
The risk factors for gestational diabetes are
- Older age when pregnant
- African or Hispanic ancestry
- Gestational diabetes in a previous pregnancy
- Having a previous baby weighing over 9 pounds
In many cases, blood glucose levels go back to pre-pregnancy levels after delivery. Up to 40% of women with gestational diabetes develop full-blown diabetes within 5-10 years after delivery. The risk may be increased in obese women.
Elevated Blood Pressure (Preeclampsia)
Preeclampsia is the development of elevated blood pressure about mid-way through pregnancy. Common symptoms may include swelling of the face and hands. The exact cause of preeclampsia is not known. Preeclampsia occurs in approximately 8% of all pregnancies.
Increased risk is associated with:
- First pregnancies
- Advanced maternal age
- African-American heritage
- Multiple pregnancies
- Past history of diabetes, high blood pressure, or kidney disease
Currently, the only way to cure preeclampsia is to deliver the baby. If it is too early to deliver the baby, the condition may be managed in the following ways:
- Bed rest
- Close monitoring
- Delivery as soon as the fetus is able to survive outside the womb
The risk of recurrent preeclampsia in subsequent pregnancies is approximately 33%.
Long-Term Effects: New Information on Stroke Risk
Recent results from two research groups show that there can be consequences of pregnancy complications extending beyond the delivery date. Dr. Cheryl Bushnell and her colleagues at Duke University Medical Center looked at medical records and found:
Women who experienced preeclampsia and gestational diabetes during their pregnancy were twice as likely or more to have a stroke, on average, 13.5 years after the pregnancy.
Dr. David Brown and colleagues conducting the Stroke Prevention in Young Women Study in Baltimore, Maryland came up with similar results. They found that:
Women with preeclampsia were 60% more likely to have a stroke in the months and years that followed their pregnancy.
While these results need to be confirmed with additional study they highlight the importance of the need for regular pre-natal visits to identify preeclampsia and gestational diabetes, as well as other problems. The results also show the need to identify ways to prevent these problems, so that the secondary consequence of stroke later in life can be avoided.
What You Can Do
Reducing Your Risk of Pregnancy Complications
It is important for all pregnant women to obtain early and ongoing prenatal care. This allows for the early recognition and treatment of these and other pregnancy-related conditions. As with any condition or disease, some risk factors are controllable, or treatable, which means you can take action to reduce that risk. Other factors are beyond your control. Risk of these complications can be reduced through:
- Maintaining a healthy weight
- Eating a balanced diet that keeps blood sugars level
- Exercising regularly
Reducing your Risk of Stroke After Pregnancy
Stroke is the nation’s third leading killer and the leading cause of adult disability. The ailment strikes as many as 750,000 Americans a year, killing over 150,000 and permanently impairing hundreds of thousands more.
To learn more about stroke NetWellness has developed a complete Stroke health topic area featuring information on:
- James AH, Bushnell CD, Jamison MG, and Myers ER. Incidence and Risk Factors for Stroke in Pregnancy and the Puerperium. Obstetrics and Gynecology 2005;106:509-516
- David W. Brown, Nicole Dueker, Denise J. Jamieson, John W. Cole, Marcella A. Wozniak, Barney J. Stern, Wayne H. Giles and Steven J. Kittner, From the Stroke Prevention in Young Women Study Preeclampsia and the Risk of Ischemic Stroke Among Young Women. Results. published online Feb 16, 2006; Stroke
For more information:
Go to the Stroke health topic.