July 29, 2011
Increase Of Strokes Among Pregnant Women, New Mothers
The rate of strokes in women who have recently given birth has increased in the last dozen years and is alarming physicians, The Telegraph is reporting.
A database of 5 to 8 million discharges from 1,000 hospitals was studied and compared the rates of strokes from 1994-95 to 2006-07 in women who were pregnant, delivering a baby and who had recently given birth, says a study published in Stroke: Journal of the American Heart Association.
"I am surprised at the magnitude of the increase, which is substantial," said Elena V. Kuklina, M.D., Ph.D., lead author of the study and senior service fellow and epidemiologist at the Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention in Atlanta, Ga.
"Our results indicate an urgent need to take a closer look. Now more and more women entering pregnancy already have some type of risk factor for stroke, such as obesity, chronic hypertension, diabetes or congenital heart disease."
"Since pregnancy by itself is a risk factor, if you have one of these other stroke risk factors, it doubles the risk."
For expectant mothers, the rate of stroke hospitalizations rose 47 percent. In pregnant women and in women who had a baby in the last 12 weeks (considered the postpartum period), the stroke rate rose 83 percent.
However, the rate remained the same for stroke hospitalizations that occurred during the time immediately surrounding childbirth. Pregnant and postpartum women ages 25 to 34 were hospitalized for stroke more often than those who were younger or older.
Furthermore, high blood pressure was more prevalent in pregnant women who were hospitalized because of stroke.
"It's best for women to enter pregnancy with ideal cardiovascular health "” without additional risk factors," Kuklina said. Next, she suggests developing a comprehensive, multidisciplinary plan that gives doctors and patients guidelines for appropriate monitoring and care before, during and after childbirth.
Physicians don't have enough guidance on which medications are best for pregnant women who have an increased risk for stroke primarily because pregnant women typically aren't included in clinical trials because most drugs pose potential harm to the fetus.
"We need to do more research on pregnant women specifically," said Kuklina, who found only 11 cases of pregnancy-related stroke in her review of previously published literature.
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