According to the Los Angeles County Department of Public Health, stroke is the second leading cause of death and the fifth leading cause of death for Angeleno women. A pregnancy-related stroke which resulted in death falls under the category of a premature death.
On July 28, 2011, a report was published online in the journal Stroke, which noted that pregnancy-related hospitalizations involving stroke have increased significantly in the United States. Researchers from the Centers for Disease Control and Prevention (CDC) reviewed data from the U.S. National Inpatient Sample from 1994 to 2007 to determine changes over time in stroke rates among pregnant women in the antenatal (before delivery), delivery, and postpartum (after delivery) periods. They found that the number of pregnancy-related stroke hospitalizations increased by 54%: 4,085 in 1994-1995 to 6,293 in 2006-2007.
The researchers explained that this trend is largely due to an increasing number of women with stroke risk factors, such as heart disease and hypertensive (high blood pressure) disorders. The changing landscape of population health of women of reproductive age is a concern, particularly, the growing numbers of women who are entering pregnancy with increased risks for cardiovascular complications, noted Elena V. Kuklina, MD, PhD, of the CDC’s Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion.
In the antenatal period, the rate of stroke hospitalizations increased 47% (from 0.15 to 0.22 per 1,000 deliveries); furthermore, in the postpartum period it increased 83% (from 0.12 to 0.22 per 1,000 deliveries). The rate remained the same for strokes that occurred during the time immediately surrounding childbirth (0.27 per 1,000 deliveries). By 2006-2007, the overall prevalence of pregnancy-related stroke hospital admissions was 0.71 per 1,000 delivery hospitalizations.
For the period 2006-2007, cerebral vascular thrombosis was the most common stroke subtype in the antenatal period (31%) and the delivery period (43%); however, hemorrhagic stroke was the most common type in the postpartum period (36%). In 2006-2007, roughly 32% of antenatal and 53% of postpartum hospitalizations involving stroke involved women with a concurrent hypertensive disorder or heart disease. Increases in the prevalence of these two conditions from the mid-1990s to the mid-2000s explained nearly all of the increase in postpartum hospitalizations with stroke during this period.
If you are pregnant and have any risk factors for a stroke, in addition to following a healthy lifestyle, it would be prudent to seek obstetrical care early on from an obstetrician or medical group affiliated with a tertiary center such as UCLA or Cedars-Sinai.
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