Stroke is uncommon during childbearing years, but pregnancy increases the risk of stroke, especially right before or right after childbirth. The specific reasons that women who are pregnant or were recently pregnant are more likely to experience a stroke are not well understood, but a new study published in JAMA Neurology has helped to shed light on this issue.

The authors of this new study set out to determine whether hypertensive disorders may play a role in maternal stroke, and particularly in the relationship between migraines and maternal stroke. To address this question, they queried a birth cohort involving 3 million live births between the years of 2007 and 2012 for incidences of stroke and incidences of migraines.

The researchers found that more than 26 thousand of the women involved in the study were diagnosed with migraine. Stroke was experienced in 843 women, and more than half of stroke occurrences were ischemic strokes. Compared to those without migraines, women with migraines were also more likely to suffer from mental health disorders, more likely to have diabetes or gestational diabetes, more likely to be obese, and more likely to use tobacco, alcohol, or drugs.

When the researchers looked specifically at how women with and without migraines differed in terms of their pregnancy-related stroke risk, they found that women who experienced migraines during pregnancy were also more likely to have a stroke during pregnancy, delivery, or postpartum than women without migraines.

Further analysis revealed that hypertensive disorders could explain 21% of the risk for stroke during pregnancy or delivery, whereas it could explain 27% of the risk for stroke postpartum. The authors therefore conclude that it is important for physicians, including cardiologists, to continue to encourage women to maintain well-controlled blood pressure before and during pregnancy.

References

1. Bandoli, G., et al. (2020). Migraines during pregnancy and the risk of maternal stroke. JAMA Neurology. doi:10.1001/jamaneurol.2020.1435
2. Pregnancy and stroke: Are you at risk? CDC.gov. https://www.cdc.gov/features/pregnancy-stroke/index.html. Accessed June 4, 2020.