ArticleEuropean heart journal2025
Adverse pregnancy outcomes and long-term risk of stroke: a Swedish nationwide co-sibling study.
Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Long-term neurological consequences of hypertensive disorders of pregnancy: Implications for postpartum monitoring and intervention.World journal of methodology · 2026Article
- Review
- Preterm Birth and Maternal Cardiovascular Risk.European cardiology · 2026Review
- The neuro-immune axis in preeclampsia: from the maternal-fetal interface to systemic dysregulation.Frontiers in immunology · 2026Review
- Early and multicomponent intervention after adverse pregnancy outcomes: an opportunity to win hearts and minds.European heart journal · 2025Article
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3 authors.
Funding
Abstract
BACKGROUND AND
aimsThe lifelong risk of stroke following adverse pregnancy outcomes, and potential causality, are unknown. This study examined five major adverse pregnancy outcomes and long-term risk of stroke in a large population-based cohort.
methodsA national cohort study was conducted of all 2 201 393 women with a singleton delivery in Sweden during 1973-2015, followed up for stroke through 2018. Cox regression was used to determine hazard ratios (HRs) for stroke associated with preterm delivery, small for gestational age, preeclampsia, other hypertensive disorders, and gestational diabetes, adjusting for other maternal factors. Co-sibling analyses assessed for potential confounding by shared familial (genetic or environmental) factors.
resultsIn 48 million person-years of follow-up, 667 774 (30%) women experienced an adverse pregnancy outcome and 35 824 (1.6%) women were diagnosed with stroke. All five adverse pregnancy outcomes were independently associated with long-term increased risks of stroke. With up to 46 years of follow-up, adjusted HRs for stroke associated with specific adverse pregnancy outcomes were: gestational diabetes, 1.86 (95% confidence interval 1.69-2.04); other hypertensive disorders, 1.82 (1.67-1.98); preterm delivery, 1.40 (1.36-1.45); preeclampsia, 1.36 (1.31-1.41); and small for gestational age, 1.26 (1.22-1.29). All HRs remained significantly elevated (1.2- to 2.5-fold) even 30-46 years after delivery. These findings were only partially explained by shared familial factors.
conclusionsIn a large national cohort, women with any of five adverse pregnancy outcomes had increased risks of stroke up to 46 years after delivery. Women with adverse pregnancy outcomes need early preventive actions and long-term follow-up to reduce their lifelong risk of stroke.
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