Although stroke is more common with advancing age, especially in the elderly, women of reproductive age may still suffer from stroke, and from its deleterious consequences. Women of reproductive age who suffer a stroke may do so either due to a specific predisposition, or due to pregnancy-related hypertensive emergencies.

To assess the risk of stroke recurrence in pregnancy and the postpartum period in women who have suffered a stroke before pregnancy.

This was a retrospective cohort study conducted at Thomas Jefferson University Hospital from January 2005 to December 2015. This is a tertiary referral center for high-risk obstetrics and one of the largest stroke referral centers for neurosurgery. All consecutive pregnant women that had a viable pregnancy (≥24 weeks of gestation) and a history of stroke prior to pregnancy were identified. The primary outcome of this study was stroke recurrence in pregnancy or the postpartum period defined as 6 weeks after delivery.

Forty-eight pregnancies with a history of stroke before pregnancy were identified in 24 women. Thirty-one pregnancies (64.6%) had a history of an ischemic stroke, 11 (22.9%) had a history of transient ischemic attack, and 6 (12.5%) had a history of a hemorrhagic stroke. There was no stroke recurrence during pregnancy or the postpartum period for the three groups of stroke. In the ischemic stroke group, 8 (25.8%) had recurrence in the non-pregnant state compared to none in the TIA and the hemorrhagic stroke group.

There was no stroke recurrence during pregnancy or the postpartum period for the three groups of stroke 1).


Yaghi S, Moon YP, Mora-McLaughlin C, Willey JZ, Cheung K, Di Tullio MR, Homma S, Kamel H, Sacco RL, Elkind MS. Left atrial enlargement and stroke recurrence: the Northern Manhattan Stroke Study. Stroke. 2015 Jun;46(6):1488-93. doi: 10.1161/STROKEAHA.115.008711. Epub 2015 Apr 23. PubMed PMID: 25908460; PubMed Central PMCID: PMC4442058.


1)
Khalifeh A, Berghella A, Moreno S, Corelli K, Leubner E, Saccone G, Daou B, Jabbour P. Stroke recurrence in pregnancy: Experience at a regional referral center. Eur J Obstet Gynecol Reprod Biol. 2019 Mar 12;236:75-78. doi: 10.1016/j.ejogrb.2019.03.005. [Epub ahead of print] PubMed PMID: 30884339.
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