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Number of Pregnancies and Risk for Stroke and Stroke Subtypes

Adnan I. Qureshi, MD; Wayne H. Giles, MD, MS; Janet B. Croft, PhD; Barney J. Stern, MD
Arch Neurol. 1997;54(2):203-206. doi:10.1001/archneur.1997.00550140073015.
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Objective:  To examine the effect of the number of pregnancies on the subsequent risk for stroke and stroke subtypes.

Design:  Prospective cohort study.

Participants:  National cohort of 3852 women aged 45 to 74 years who participated in the first National Health and Nutrition Examination Survey Epidemiology Follow-up Study.

Main Outcome Measures:  Stroke, cerebral infarction, and intracerebral hemorrhage during a 20-year follow-up period.

Results:  After adjusting for differences in age, women with 6 or more pregnancies were at an increased risk for any type of stroke (relative risk [RR]=1.7; 95% confidence interval [CI], 1.2-2.3) and cerebral infarction (RR=1.6; 95% CI, 1.2-2.3). Adjustment for stroke risk factors explained some but not all of the risk associated with pregnancy (RR=1.3; 95% CI, 0.9-1.9 for all stroke, and RR=1.3; 95% CI, 0.9-1.9 for cerebral infarction). The rate of intracerebral hemorrhage was 3-fold higher among women who had been pregnant when compared with nulligravida women; however, this finding did not reach statistical significance possibly because of the small number of intracerebral hemorrhages (n=33).

Conclusion:  The number of pregnancies may influence the risk for stroke, particularly cerebral infarction, in women.

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