Common Pregnancy Complications Linked to Increased Future Stroke Risk

Recent research has unveiled significant connections between common pregnancy complications and an elevated risk of stroke in later life. The study, led by Professor Casey Crump from the Department of Family and Community Medicine at UTHealth Houston, examined the medical histories of over two million women over a span of 40 years. The findings, published in the European Heart Journal on June 24, 2025, highlight how conditions such as preterm delivery, low birth weight, and gestational diabetes may act as early indicators of future cardiovascular issues.

The comprehensive analysis utilized data from a Swedish national cohort, encompassing 2,201,393 singleton pregnancies recorded between 1973 and 2015. Approximately 30% of the women studied (667,774) experienced at least one complication, including preterm delivery (defined as delivery before 37 weeks), having a baby categorized as small for gestational age (the smallest 10% of newborns), high blood pressure during pregnancy, and gestational diabetes.

The researchers monitored which women encountered stroke incidents up to 2018, comparing the rates between those with pregnancy complications and those without. The results indicated that women with high blood pressure during pregnancy faced nearly double the risk of stroke, while those who experienced preterm delivery had a 40% increased risk. Women with preeclampsia, a severe form of high blood pressure in pregnancy, had a 36% higher risk, and those with low-birth-weight infants faced a 26% increased risk. Notably, the risks intensified for women experiencing two or more complications.

Professor Crump emphasized the importance of recognizing that pregnancy serves as a 'natural stress test' that can reveal underlying cardiovascular risks. "Up to one-third of all pregnancies are affected by one of these complications. However, the long-term cardiovascular risks for these women remain poorly understood and often overlooked in routine clinical care," he stated.

The study's unique aspect lies in its comprehensive approach to assessing familial and genetic factors. By comparing stroke risks among sisters in the cohort, the researchers sought to determine if shared genetic predispositions could explain the observed correlations. However, the findings suggested that familial factors did not fully account for the link between pregnancy complications and future stroke risk.

Additionally, the study highlights the potential physiological mechanisms connecting pregnancy complications to stroke risk. Common features among these complications, such as placental abnormalities and inflammation, may affect small blood vessels’ structure and function. These changes, which can persist post-pregnancy, could contribute to the heightened stroke risk observed in these women.

In an editorial accompanying the study, Dr. Abbi Lane from the University of Michigan noted the implications of these findings for preventive care. "Stroke is a significant cause of death and disability, and understanding sex-specific, earlier life stroke risk factors can help target high-risk individuals for preventive interventions," she stated. Dr. Lane advocated for a multifaceted approach to managing the health of women who experience adverse pregnancy outcomes, suggesting that addressing modifiable risk factors early could help mitigate long-term cardiovascular risks.

The implications of this research are profound. As adverse pregnancy outcomes (APOs) occur in approximately 30% of pregnancies, the potential for preventive measures could significantly reduce the incidence of strokes, which are estimated to be 90% preventable. This study underscores the necessity for healthcare providers to recognize pregnancy complications as critical indicators of future cardiovascular health.

In conclusion, the findings advocate for heightened awareness among both women and healthcare professionals regarding the long-term health implications of pregnancy complications. Early identification and intervention for women experiencing these complications could lead to improved outcomes and a reduction in stroke risk throughout their lives.