Adverse pregnancy outcomes associated with increased risk of midlife stroke
A history of adverse pregnancy outcomes (APO) is associated with higher odds of midlife stroke. APO included preterm delivery, low birth weight, preeclampsia, placental abruption, and stillbirth in the study published in the peer-reviewed Journal of Women's Health.
Stroke is a leading cause of death and disability in women in the United States. While the incidence of stroke in older age groups is decreasing, stroke and stroke risk factors in younger and middle-aged U.S. women are on the rise.
Eliza Miller, MD from Vagelos College of Physicians and Surgeons, Columbia University, and coauthors, found that stroke before age 60 was reported by 5% of 164 women with APOs, compared to 1% of women without APOs – a significant difference – with a mean age at stroke of 49 years.
"Remarkably, nearly 4 in 10 women in our sample who suffered a stroke before the age of 60 had a history of APOs," stated the investigators. "Our results suggest that common APOs may offer a glimpse into women's cerebrovascular health, and a unique opportunity to implement primary preventive strategies in a population at high risk of future stroke."
"Given the findings of Miller and colleagues, providers should consider women with a history of adverse pregnancy outcomes at increased risk of stroke during midlife and implement preventive measures," says Journal of Women's Health Editor-in-Chief Susan G. Kornstein, MD, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA.
In this cross-sectional analysis of women in a nationally representative longitudinal study of U.S. respondents, a self-reported history of APOs was independently associated with a greater than twofold increased odds of stroke in midlife. Our results suggest that clinicians caring for obstetric patients can play a critical role in early identification of young women who should be targeted for intensive interventions aimed at primary stroke prevention. The role of multidisciplinary postpartum clinics and "cardio-obstetrics" has emerged as a promising strategy for optimizing heart health in women.
For more information:
Eliza C. Miller et al, Women with Adverse Pregnancy Outcomes Have Higher Odds of Midlife Stroke: The Population Assessment of Tobacco and Health Study, Journal of Women's Health (2021). DOI: 10.1089/jwh.2021.0184
