Women with certain pregnancy complications face more than double the risk of stroke before age 50, according to new research published August 6, 2025, in Neurology®, the medical journal of the American Academy of Neurology.
The study, which examined over 1,000 women with a history of pregnancy, identified a strong association between complications such as preeclampsia, preterm birth, gestational diabetes, miscarriage, and stillbirth, and the risk of ischemic stroke—especially before midlife. Researchers emphasized that the findings reflect a correlation, not causation.
The analysis included 1,072 women aged 18 to 49 who had experienced at least one pregnancy. Of those, 358 had suffered an ischemic stroke, while 714 had not. Scientists reviewed the participants’ histories for complications, including high blood pressure during pregnancy (preeclampsia), premature delivery before 37 weeks, small-for-gestational-age births, and pregnancy loss.
Results showed that 51% of stroke patients had experienced at least one pregnancy complication, compared to just 31% of those without stroke. After adjusting for maternal age at first pregnancy, researchers found that women who suffered a stroke were more than twice as likely to have had a pregnancy complication.
Among all complications, stillbirth showed the strongest link, with affected participants nearly five times more likely to have had a stroke. Preeclampsia was associated with a fourfold increase in risk, while preterm and small-for-gestational-age births were linked to nearly triple the risk. However, researchers cautioned that the number of stillbirth cases was relatively small.
The study also found that preeclampsia and preterm birth were particularly associated with strokes caused by large artery disease—a form commonly related to atherosclerosis, the buildup of plaque in the arteries.
“Physicians should consider a woman’s pregnancy history when evaluating her stroke risk,” said study author Dr. De Leeuw. “Our findings support the idea that cardiovascular prevention efforts might need to begin earlier in life—well before menopause.”
Dr. De Leeuw also called for further studies on how lifestyle interventions could reduce long-term cardiovascular risks in women who experienced pregnancy complications.
Researchers acknowledged several limitations, including reliance on self-reported data for some complications and the inability to account for all potential stroke risk factors, such as elevated blood pressure and cholesterol levels.
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