Stroke risk linked to pregnancy history

A Dutch study links high-risk pregnancy complications to a higher chance of stroke before age 50.

Stroke risk before age 50 rises for women with pregnancy complications

Researchers in the Netherlands studied more than 1,000 women aged 18 to 49 who had been pregnant at least once. They looked at whether six pregnancy complications occurred—pre-eclampsia, pre-term birth, small for gestational age babies, gestational diabetes, miscarriage, and stillbirth—and whether the women later had a stroke. Women who had any of these pregnancy complications were more than twice as likely to report a stroke, and stillbirth showed the strongest link with an estimated fivefold increase in risk.

The study also found that strokes linked to large-artery disease were more common among those with pregnancy complications, suggesting vascular changes may be involved. Lead author Dr Frank-Erik de Leeuw said doctors should ask about pregnancy history when assessing stroke risk and that prevention may need to start earlier in life. The authors note that pregnancy itself raises stroke risk by increasing blood volume and clotting factors, with the highest risk occurring in the six weeks after delivery.

These results add to a growing view that reproductive health and cardiovascular risk are linked. If confirmed in broader populations, the finding could push clinicians to consider pregnancy history alongside traditional risk factors when evaluating a woman’s chance of stroke. At the same time, the study’s observational design means it cannot prove causation, and its Dutch cohort may not fully reflect other countries. The message is to integrate reproductive history into risk checks thoughtfully, investing in broader research to verify applicability and identify actionable prevention steps.

In practice, the work points toward earlier, more holistic cardiovascular care for women. It invites policymakers and clinicians to think beyond menopause when building lifelong health strategies, and to explore lifestyle interventions that could mitigate risk for those with pregnancy complications.

Highlights

Longer-term research could change how we protect women’s heart health.