New Guidelines Target Maternal Stroke Risks in Pregnancy and Postpartum

The American Heart Association, in collaboration with the American College of Obstetricians & Gynecologists, has issued a groundbreaking scientific statement titled "Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum." This comprehensive document addresses the critical yet often overlooked risk of stroke during pregnancy and the postpartum period, which affects approximately 20 to 40 out of every 100,000 pregnancies and accounts for 4-6% of pregnancy-related deaths annually in the U.S. The statement, led by Dr. Eliza Miller from the University of Pittsburgh, emphasizes that while maternal stroke is rare, it can lead to severe complications including long-term disability, neurological deficits, and death for both mother and baby. Key players in this initiative include the American Heart Association's Women’s Health Science Committee and Stroke Council, along with co-authors like Dr. Andrea Shields, who contributed to outlining evidence-based strategies for prevention, diagnosis, treatment, and recovery.

The core message of the statement revolves around the importance of increased awareness and coordinated care to mitigate stroke risks. It details specific risk factors such as chronic hypertension, preeclampsia, advanced maternal age (35 or older), diabetes, obesity, and racial disparities, noting that pregnant Black women are twice as likely to experience a stroke compared to white women. Prevention strategies highlighted include managing high blood pressure through guidelines like the 2025 High Blood Pressure Guideline, adopting healthy lifestyle behaviors from Life’s Essential 8, and using anti-clotting medications when necessary. The statement also stresses the need for timely diagnosis, urging healthcare professionals to recognize stroke symptoms promptly and utilize safe imaging techniques like computed tomography for pregnant patients. Treatment recommendations include not delaying acute stroke interventions, with options like mechanical thrombectomy for large-vessel blockages, and supporting recovery through multidisciplinary rehabilitation teams to address post-stroke challenges such as fatigue and depression.

Why this matters is underscored by the statement's call for more research, including clinical trials, to refine risk assessment and improve maternal and fetal health outcomes. The impact extends beyond immediate medical care, as it advocates for emotional and practical support for stroke survivors, emphasizing that "babies depend on their mothers' well-being." By integrating resources like the American Heart Association's 2026 Heart Disease and Stroke Statistics and guidelines for primary prevention, this initiative aims to save lives and enhance the quality of life for families affected by maternal stroke, making it a vital step forward in women's healthcare.