Pregnancy and Stroke: Are You At Risk?

Photo of hands of African American women forming heart shape on pregnant belly

Stroke can happen to anyone at any time, even new moms. Learn more about the connection between pregnancy and stroke and what you can do to keep yourself and your baby healthy.

When Brooke Bergfeld developed an extreme headache about a week after giving birth, she assumed it was just another migraine, as she’d had during her pregnancy. When her left arm suddenly hurt, she figured it was due to muscle aches from carrying around a new baby.

But her mom noticed Brooke’s slurred voice and drooping face—two classic signs of stroke—and called 9-1-1 right away. At the hospital, doctors performed a thrombectomy, a surgery to remove a blood clot. Today, Brooke is still dealing with how the stroke changed her life and is working to educate others about stroke.

How Common Is Stroke During or After Pregnancy?

Stroke is not common in pregnancy or during the years women can have children. But pregnancy does put women at higher risk for stroke, and the rate of pregnancy-related stroke is rising.1

Photo of pregnant Caucasian woman holding belly

Most women in the United States have healthy pregnancies and deliveries, but sometimes problems can happen that increase the risk for stroke, such as high blood pressure during pregnancy.

How Is Stroke Related to Pregnancy?

Pregnancy is like a stress test; it can strain the heart and blood vessels. This is partly because the body carries more weight during pregnancy, but changing hormones also play a role.1,2 Most women in the United States have healthy pregnancies and deliveries, but sometimes problems can happen that increase the risk for stroke. These problems include:

  • High blood pressure during pregnancy. Some women who had healthy blood pressure levels before getting pregnant can develop high blood pressure during pregnancy. Having high blood pressure during pregnancy is the leading cause of stroke in pregnant women or women who have recently given birth.1 High blood pressure happens in up to 12% of pregnancies in the United States.3

Preeclampsia is a more severe type of high blood pressure during pregnancy. Preeclampsia can cause vision problems, headaches, swelling in the hands and face, premature delivery, and a baby with low birth weight. At its most severe, preeclampsia can cause seizures (eclampsia) and lead to stroke.

Women who had preeclampsia have a much higher risk of having high blood pressure, kidney disease, heart disease, and stroke later in life than women who did not have high blood pressure during pregnancy.1

  • Gestational diabetes. Some women suddenly develop problems with blood sugar during pregnancy, a condition called gestational diabetes. This happens in as many as 1 in 10 pregnancies in the United States.4 Gestational diabetes raises the risk for high blood pressure during pregnancy and for heart disease and stroke later in life.5
  • Blood clots. Being pregnant makes the blood more likely to clot, which can lead to stroke. This increased risk for clotting happens in part because swelling from pregnancy can reduce blood flow to the lower legs. When blood does not circulate well, it is more likely to clot. During late pregnancy, the body also makes more of a substance that helps blood clot. This helps protect women from bleeding too much when they give birth, but it also raises the risk for stroke.3

If you think someone may be having a stroke, act F.A.S.T. and take the following actions:

F — Face: Ask the person to smile. Does one side of the face droop?
A — Arms: Ask the person to raise both arms. Does one arm drift downward?
S — Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T — Time: If you see any of these signs, call 9-1-1 right away.

What Are the Symptoms of Stroke During or After Pregnancy?

Like Brooke, many women may mistake their stroke symptoms, including headaches, dizziness, or tingling arms, for issues related to pregnancy and a new baby. If your symptoms appear suddenly, that may be a clue that you are having a stroke. Learn the key stroke symptoms:

  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination
  • Sudden severe headache with no known cause

If you notice any of these symptoms in yourself or another person, call 9-1-1 right away.

5 Way to Keep Yourself and Your Baby Healthy During Pregnancy

The best way to protect yourself and have a healthy pregnancy is to be in good health before you get pregnant.

Do not smoke. Using tobacco products before or during pregnancy raises the risk for stroke.4 If you don’t smoke, don’t start. If you do smoke, learn how to quit.

Maintain a healthy weight. This will also help you have healthier blood pressure and blood sugar levels during pregnancy. When you get pregnant, aim to gain a healthy amount of weight. Learn more about healthy weight.

Choose healthy foods. An eating plan rich in whole grains, nuts, healthy fats, fruits, and vegetables and low in sodium can support healthy blood pressure and blood sugar levels. Learn more about healthy eating.

Stay physically active. Women with healthy pregnancies should get about 30 minutes of moderate activity most days.6 Learn more about physical activity during pregnancy.

Work with your health care team. Talk to your doctor about your risk for stroke or other problems during pregnancy. Your health care team will closely monitor your blood pressure and blood sugar throughout your pregnancy.

More Information

From CDC:

From other websites:

References
  1. Bushnell C, McCullough LD, Awad IA, et al, on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research. Guidelines for the Prevention of Stroke in WomenExternal. Stroke 2014;45(5):1545–1588.
  2. National Stroke Association. (N.d.) Women and StrokeExternal.
  3. Grear KE, Bushnell CD. Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment and EpidemiologyExternal.Clin Obstet Gynecol 2013;56(2):350–359.
  4. CDC. Gestational diabetes [updated 2017 July 25].
  5. Shostrom DCV, Sun Y, Oleson JJ, Snetselaar LG, Bao W. History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US WomenExternal. Front Endocrinol2017;8:144.
  6. Task Force on Hypertension in Pregnancy. Hypertension in PregnancyExternal. Washington, DC: American College of Obstetricians and Gynecologists; 2013.