Statement Highlights:<\/p>\n
\n\tA new scientific statement from the American Heart Association and endorsed by the American College of Obstetricians & Gynecologists details risk factors for pregnancy-related stroke and offers suggestions for stroke prevention, rapid diagnosis, timely treatment and recovery during pregnancy and postpartum.
\n\tStroke prevention strategies during pregnancy and postpartum include risk factor modification through healthy lifestyle behaviors, managing high blood pressure and anti-clotting medications, if needed.
\n\tSupporting emotional and physical recovery after stroke is also essential to improve health outcomes for mothers and babies impacted by maternal stroke.
\n\tMore research on maternal stroke, including clinical trials, is needed to refine stroke risk assessment, to expand treatment options and to improve maternal and fetal health.
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Embargoed until 4:00 a.m. CT\/5:00 a.m. ET, Wed., Jan. 28, 2026<\/p>\n
DALLAS, Jan. 28, 2026 \u2014 Stroke<\/a> during pregnancy or shortly after delivery is rare, yet it can be life-threatening. Increased awareness and coordinated care of women during pregnancy for stroke risk factors, diagnosis, treatment and recovery are crucial to the health of both mother and baby affected by a stroke, according to a new American Heart Association scientific statement published today in the Association\u2019s journal Stroke and endorsed by the American College of Obstetricians & Gynecologists.<\/p>\n The new scientific statement, \u201cPrevention and Treatment of Maternal Stroke in Pregnancy and Postpartum,\u201d summarizes the latest scientific research detailing the risk factors and causes of stroke during and after pregnancy, and offers suggestions for maternal stroke prevention, management and postpartum recovery.<\/p>\n \u201cWhen a stroke occurs during pregnancy or the postpartum period, it can lead to serious complications for both the mother and baby, including neurological deficits, long-term disability, increased risk of future strokes and death,\u201d said Eliza Miller, M.D., M.S., chair of the writing group and associate professor of neurology and chief of women\u2019s neurology at the University of Pittsburgh in Pennsylvania. \u201cControlling blood pressure and other stroke risks before and after delivery, responding immediately to stroke warning signs and providing timely treatment can help save lives and improve outcomes for mothers and their babies,\u201d Miller said.<\/p>\n According to the American Heart Association\u2019s 2026 Heart Disease and Stroke Statistics<\/a>, stroke is now the #4 leading cause of death in the U.S. There are two types of stroke<\/a>: an ischemic stroke<\/a> is when a blood vessel supplying blood to the brain is blocked by a clot, and a hemorrhagic stroke<\/a> is when a blood vessel ruptures and bleeds into the brain. A stroke occurs in approximately 20 to 40 of every 100,000 pregnancies, and stroke is estimated to account for around 4-6% of pregnancy-related deaths annually in the U.S.<\/p>\n Pregnant and postpartum women have historically been excluded from clinical trials due to ethical concerns about the safety to the pregnant woman and the fetus. As a result, there is limited evidence for health care professionals to manage stroke in these patients. Over the past decade, however, a growing body of observational research has emerged to inform optimal care.<\/p>\n Risk factors for stroke during and after pregnancy<\/p>\n The physiological changes that occur during pregnancy, including changes within the vascular system (vessels that carry blood throughout the body) and hormonal shifts, can contribute to a woman\u2019s risk of stroke. Other risk factors for pregnancy-associated stroke include:<\/p>\n
As with other differences in maternal health outcomes, stroke disproportionately affects people of racial and ethnic minorities. A 2020 meta-analysis found that pregnant Black women are twice as likely to have a stroke compared to pregnant white women, even after adjusting for socioeconomic factors.<\/p>\n Emphasis on primary prevention<\/p>\n The statement authors emphasize that lowering risks of pregnancy-related stroke ideally begins before conception. Women who are considering pregnancy are encouraged to follow primary stroke prevention strategies detailed in the 2024 American Heart Association\/American Stroke Association Guideline for the Primary Prevention of Stroke<\/a>, as well as healthy lifestyle behaviors included in Life\u2019s Essential 8<\/a>, such as smoking cessation, healthy eating, recommended physical activity and weight management.<\/p>\n The majority of maternal strokes are preventable with earlier and more aggressive blood pressure control, according to the statement. The Association\u2019s 2025 High Blood Pressure Guideline<\/a> uses ACOG\u2019s diagnostic criteria for hypertension in pregnancy, defined as systolic blood pressure (the top number) \u2265140 mm Hg or diastolic blood pressure (the bottom number) \u226590 mm Hg.<\/p>\n \u201cPreeclampsia and eclampsia can occur before, during or after delivery, and the early postpartum period is actually the highest risk time for stroke. Very close monitoring of blood pressure is essential,\u201d said Miller.<\/p>\n Treating high blood pressure during pregnancy and postpartum with antihypertensive medication may help prevent the complications associated with severe hypertension and preeclampsia. Previous studies have found that daily low-dose aspirin significantly reduces the risk of preeclampsia in high-risk individuals compared with placebo. Observational data also suggest a correlation between tighter blood pressure control after delivery and decreased rates of postpartum emergency department visits and hospital readmissions.<\/p>\n Diagnosis and treatment of maternal stroke<\/p>\n The statement urges all health care professionals who care for pregnant patients, including obstetricians, family medicine practitioners and nurses, to be trained to recognize stroke symptoms<\/a> so they can promptly start treatment and potentially minimize stroke-related complications.<\/p>\n \u201cIt is crucial for women who are pregnant or have recently given birth and have symptoms of new neurological deficits or severe headache, especially if they also have elevated blood pressure, to be immediately evaluated for possible stroke,\u201d said Miller.<\/p>\n Diagnosing a stroke using imaging techniques, including computed tomography, computed tomography angiography and magnetic resonance imaging without contrast, are all safe for rapid evaluation of pregnant patients with acute stroke symptoms.<\/p>\n The statement authors emphasize that pregnancy is not a reason to delay or interfere with recommended treatment for acute stroke. There are various anti-clotting medications available that are safe for pregnant and lactating women. Mechanical thrombectomy (surgical removal of a blood clot) may be needed for patients with large-vessel blockages.<\/p>\n Considerations for delivery and recovery after stroke<\/p>\n The writing group notes that stroke during pregnancy is not an indication for immediate delivery if the mother\u2019s condition is stable and the fetus is preterm (before 37 weeks of gestation). If, however, the mother\u2019s neurological or cardiovascular status worsens, preterm delivery may be necessary. When possible, it is preferable to avoid cesarean delivery to minimize the associated surgical risks and changes in blood pressure.<\/p>\n Survivors of pregnancy-associated stroke face unique challenges such as caring for an infant, and require support from a multidisciplinary rehabilitation team. Mood and sleep disorders are common after stroke and may be intensified by postpartum factors such as hormonal shifts, breastfeeding and disrupted sleep. Post-stroke fatigue, anxiety and depression can occur in stroke survivors and are linked to worse outcomes. These conditions may be managed with behavioral therapy, counseling with mental health specialists and medication as needed. Engaging patients\u2019 family members, caregivers and support networks in rehabilitation planning and goal setting is also important to improve recovery and long-term health outcomes.<\/p>\n \u201cBabies depend on their mothers’ well-being, and supporting recovery after stroke, both emotionally and practically, is essential so mothers can heal and families can thrive,\u201d Miller said.\u00a0<\/p>\n This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association\u2019s Women\u2019s Health Science Committee of the Council on Clinical Cardiology and Stroke Council. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association\u2019s official clinical practice recommendations.<\/p>\n Co-authors are Vice Chair Andrea Shields, M.D., M.S.; Natalie A. Bello, M.D., M.P.H.; Peng R. Chen, M.D.; Lisa Leffert, M.D.; Michelle Leppert, M.D., FAHA; Tracy Madsen, M.D., Ph.D., FAHA; Katelyn Skeels, M.S.N., A.P.R.N., F.N.P.-C.; Alan Tita, M.D., Ph.D.; and Eduard Valdes, M.D. Authors\u2019 disclosures are listed in the manuscript.<\/p>\n The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available\u00a0here<\/a>.<\/p>\n Additional Resources:<\/p>\n ###<\/p>\n About the American Heart Association <\/p>\n The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public\u2019s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org<\/a>, Facebook<\/a>, X<\/a> or by calling 1-800-AHA-USA1.<\/p>\n For Media Inquiries: 214-706-1173<\/p>\n Amanda Ebert: Amanda.Ebert@heart.org<\/a><\/p>\n For Public Inquiries: 1-800-AHA-USA1 (242-8721)<\/p>\n heart.org<\/a> and stroke.org<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Statement Highlights:
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\n\tChronic hypertension (high blood pressure<\/a> before pregnancy or diagnosed before 20 weeks of pregnancy)
\n\tHypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia<\/a>\/eclampsia
\n\tAdvanced maternal age (defined as 35 years or older)
\n\tDiabetes
\n\tObesity<\/a>
\n\tMigraine, particularly with aura
\n\tInfections
\n\tHeart or cerebrovascular disease
\n\tClotting disorders
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