By AMERICAN HEART ASSOCIATION NEWS

0525-News-Preeclampsia_WP

Urinary tract infections, chronic high blood pressure and bleeding or clotting disorders may increase the risk of pregnancy-associated stroke in women with preeclampsia, new data suggest.

In a study published in the American Heart Association journal Stroke, women with preeclampsia and pregnancy-related stroke were seven times more likely to have severe preeclampsia or eclampsia compared with women who had preeclampsia but didn’t have a stroke.

They were also three times more likely to have infections when they arrived at the hospital, or had high blood pressure before developing preeclampsia or blood disorders involving clots or excessive bleeding.

Women with preeclampsia — a high blood pressure disorder unique to pregnancy — are at higher risk of stroke during pregnancy and after delivery. But while preeclampsia affects 3 percent to 8 percent of all pregnancies, pregnancy-related stroke is rare.

“Preeclampsia is a very common disorder, and a lot of people are not aware of its association with stroke,” said Eliza Miller, M.D., the study’s lead author and a vascular neurology fellow at New York-Presbyterian Hospital/Columbia University Medical Center in New York City.

“Women with preeclampsia should take any neurological symptoms, such as severe headache, very seriously, especially during the postpartum period. This needs to be a major focus of future stroke research in women.”

For the study, researchers identified 88,857 women with preeclampsia admitted to hospitals in New York state in 2003-2012. Of that number, 197 had pregnancy-associated stroke.

Using billing data from the New York State Department of Health inpatient database, researchers compared women ages 12 to 55 with preeclampsia and pregnancy-associated stroke to a matched control group of women with preeclampsia who did not have strokes.

Among the women with preeclampsia and stroke, most strokes occurred postpartum, after women had been discharged home after delivery. More than one in 10 of the preeclampsia-related strokes were fatal.

The link with urinary tract infections was interesting “because those infections are not only treatable, but could be preventable,” Miller said.

Reliance on patients’ billing data limited the level of detail researchers could analyze and restricted them from drawing definitive conclusions. But the associations were strong enough to help generate new ideas and directions for more research.