Ischemic stroke increases expectant mother’s risk for another stroke during or soon after pregnancy

A history of ischemic stroke – stroke caused by blocked blood vessels – more than doubles a woman’s risk of experiencing another stroke during pregnancy or within six weeks of childbirth, according to preliminary research presented at the American Stroke Association’s International Stroke Conference 2026, scheduled for February 4-6, 2026, in New Orleans.

Understanding the Increased Risk

The study addresses a critical question for women who have previously experienced an ischemic stroke: what are the risks associated with pregnancy? Researchers found that the increased risk of recurrent stroke during and after pregnancy isn’t linked to other known risk factors. This finding, according to study lead author Adnan I. Qureshi, M.D., professor of neurology at the University of Missouri in Columbia, Missouri, and founder of Zeenat Qureshi Stroke Institutes, allows for more informed decisions between women and their healthcare providers.

How the Study Was Conducted

Researchers analyzed electronic health records from hospitals across the U.S. between 2015 and 2025. They compared stroke rates in women with and without a prior stroke history who had recently given birth, focusing on the early postpartum period. The data included 1,192 pregnant women with a previous stroke and 219,287 pregnant women without a prior stroke.

The analysis revealed a significantly higher stroke rate among women with a prior stroke: 415 new ischemic strokes occurred in the 1,192 pregnant women with a stroke history (34.82%), compared to 737 new strokes among the 219,287 pregnant women without a prior stroke (0.34%). After accounting for factors like race, other medical conditions, and medications, women with a history of stroke were more than twice as likely to experience another stroke during pregnancy or in the early postpartum period.

Additional Risk Factors

The study also identified additional factors that may increase risk. Women with a previous heart attack were 82% more likely to experience an ischemic stroke during pregnancy or the early postpartum period, while those with obesity were 25% more likely.

Jennifer Lewey, M.D., M.P.H., chair of the writing committee of the 2024 American Heart Association Scientific Statement, emphasized the potentially devastating consequences of stroke during or after pregnancy. She noted that the study highlights an opportunity to prevent maternal stroke among those at highest risk, recommending pre-conception counseling and a collaborative approach between neurologists and obstetricians to develop tailored surveillance and treatment plans.

What Could Happen Next

Study authors suggest that intensified preventive efforts are needed for women with a history of ischemic stroke. Future research could explore specific strategies to lower the risk of a second stroke in this population. Proven strategies for stroke risk reduction include identifying the cause of the first stroke, reviewing medications during pregnancy, managing blood pressure, and maintaining a healthy lifestyle through diet and exercise.

Dr. Qureshi stressed the importance of managing pregnant women with a stroke history at healthcare centers experienced in high-risk pregnancies, noting that there are currently no specific clinical guidelines for these cases. He hopes this study will lead to better identification and categorization of these women to ensure they receive a higher level of care from the outset.

Frequently Asked Questions

What did the study find regarding stroke risk in pregnant women with a prior stroke?

The study found that women with a history of ischemic stroke were more than twice as likely to have a second stroke during pregnancy and in the six weeks after childbirth compared to women with no prior stroke history.

Are there any other factors that increase stroke risk during pregnancy?

Yes, the study found that a previous heart attack increased the risk of ischemic stroke during pregnancy by 82%, and obesity increased the risk by 25%.

What is being recommended to improve care for pregnant women with a history of stroke?

Researchers recommend pre-conception counseling to discuss stroke risk, and a collaborative approach between neurologists and obstetricians to develop a surveillance and treatment plan during pregnancy and the postpartum period.

Considering the increased risks identified in this study, what role do you think personalized healthcare plans will play in ensuring safer pregnancies for women with a history of stroke?