Pregnancy-related stroke more common among black women

The risk of pregnancy-related stroke is much higher among black women than among white women, according to preliminary research to be presented in Honolulu at the American Stroke Association's International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.

Stroke is the fifth-leading cause of death and a major cause of long-term disability in the United States. Women are more likely than men to have a stroke and to die as a result, and pregnancy increases the risk. In addition, blacks are at greater risk than whites.

To find out if stroke risk differs by race during and after delivery researchers studied records from the Nationwide Inpatient Sample, a publicly available database of hospitalizations, from 1998 to 2014. These records comprised nearly 68 million delivery hospitalizations and 1.1 million post-delivery hospitalizations for women between 15- to 54-years-old.

Of the nearly 68 million delivery hospitalizations, 8,241 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 percent higher risk for stroke during delivery and 66 percent higher risk for stroke during postpartum admissions than white women.
• Black and Hispanic women with pregnancy-related , 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.

"Further research is needed to better understand if these high-risk groups would benefit from a more aggressive blood pressure control," said Maria Daniela Zambrano, M.D., study lead author and fellow in vascular neurology at Columbia University in New York. "It is also important to carefully look at all of the modifiable risk factors that could help prevent stroke in these groups."

Modifiable stroke risk factors include lifestyle changes, controlling high blood pressure, high cholesterol, weight, diabetes and healthy eating, smoking cessation and physically activity.

"We have to identify our obstetric patients at higher risk of cerebrovascular complications and develop an individualized prenatal care plan after considering all their predisposing factors including race," Zambrano said.

The study used information from a national registry, which does not always record patients' race and ethnicity.