Maternal Stroke Risks at Delivery Include Infections, Race, Preliminary Research Finds

Stroke-related health risks of giving birth are highlighted in 2 posters that will be presented at the American Stroke Association's International Stroke Conference 2019, being held February 6-9, 2019, in Honolulu, Hawaii.

According to 1 set of preliminary research, the risk of pregnancy-related stroke is much higher among black women than among white women. Stroke is the fifth-leading cause of death in the United States, and women are more likely than men to have a stroke and to die as a result, the organization said in a statement. In addition, blacks are at a greater risk of suffering a stroke than whites.

It is already known that pregnancy increases stroke risk. To discover if stroke risk differs by race during and after delivery, researchers studied records from the Nationwide Inpatient Sample from 1998 to 2014. These records comprised nearly 68 million delivery hospitalizations and 1.1 million postdelivery hospitalizations for women aged 15 to 54.

Of the nearly 68 million delivery hospitalizations, 8241 women were diagnosed with stroke during delivery. Of the 1.1 million hospitalizations after delivery, 11,073 women were readmitted for stroke. After studying the deliveries, they found:

• Black women were at 64% higher risk for stroke during delivery and 66% higher risk for stroke during postpartum admissions than white women.
• Black and Hispanic women with pregnancy-related complications, such as preeclampsia, were twice as likely as white women to have a stroke during delivery.
• Postpartum stroke hospitalizations for Hispanic women did not differ from white women.

Another poster and presentation shows an association between women diagnosed with an infection during delivery and a much greater risk of stroke after delivery.

Researchers examined more than 3.5 million delivery hospitalizations from the 2013 Healthcare Cost and Utilization Project National Readmissions Database, which compiles information on US hospital care. Out of 79,656 women who were readmitted to the hospital within 1 month after delivery, 225 were readmitted for stroke.

Researchers found:

• A strong relationship between infections, including bladder infections, pneumonia, and sepsis during hospitalization for delivery and stroke within the following month.
• Women with an infection during delivery hospitalization were more than 5 times as likely to be readmitted to the hospital for stroke.
• Women readmitted for stroke were more than 3 times as likely to have had an infection during their delivery hospitalization, compared with women readmitted for other reasons.

The increased stroke risk occurred regardless of whether women had pregnancy-related complications.