Since stroke is rare in women of child-bearing age, there is not a large pool of data regarding women with a history of stroke who become pregnant. However, the risk of recurrent ischemic stroke is likely low.
In one review, 441 women with a history of ischemic stroke were evaluated (373 with arterial ischemic stroke and 68 with cerebral venous thrombosis). During a mean follow-up of 5 years, there were 13 recurrent arterial ischemic strokes and no recurrences of cerebral venous thrombosis. The overall risk was 1% at one year and 2.3% at five years. The risk of recurrence during pregnancy or the puerperium was 1.8%, but the relative risk of recurrence was significantly higher during the postpartum period. The outcome of the 187 subsequent pregnancies was similar to that expected from the general population. The authors of this study concluded that a previous ischemic stroke is not a contraindication to a subsequent pregnancy.
Since the condition is rare, it is difficult to precisely determine the risk for a given individual. The likely modifying factors are below:
- Maternal age (older being worse).
- The interval since the original event (shorter being worse).
- Other comorbidities
Also, if the cause of the stroke were thrombotic in nature, pregnancy is a time of increased thrombosis in general, and could increase the risk of recurrence.
For women with a history of stroke, a thorough evaluation is necessary prior to pregnancy to best estimate the risk of recurrent stroke during pregnancy. For more information regarding pregnancy, visit our FAQ page or blog page. For more information about MFM, visit the about page.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!