Miscarriage and stillbirth linked to increased stroke risk, study finds

Some parts of women’s lives have long been associated with having an increased risk of stroke, such as taking the contraceptive pill, being pregnant, or suffering frequent migraines. In fact, just by the virtue of living longer than men, women are more likely to experience a stroke – which is the fourth leading cause of death in the UK.

Though around 80 per cent of strokes can be prevented by making lifestyle improvements like quitting smoking or taking part in regular exercise, a recent study published in the British Medical Journal (BMJ) reports having found a link between fertility issues and an increased risk of stroke later in life.

While infertility and pregnancy loss can be due to a variety of genetic or hormonal factors, the BMJ paper led by Dr. Gita Mishra calls for further infertility research after discovering an 82 per cent higher risk of fatal stroke in women who have had three or more miscarriages. To draw this link, Queensland professor of Life Course Epidemiology Dr. Mishra collected data from eight long-term studies in seven countries that covered over 618,000 women and cross-referenced their personal questionnaires with public stroke data.

Just over one in six of the respondents had experienced either a stillbirth or miscarriage and, when compared to women who had neither, the study discovered a 35 per cent increased risk of non-fatal strokes as well as the almost doubling in risk of a fatal stroke.

Dr. Mishra told that the mechanism causing this increased risk of stroke in women with fertility problems is an area of science currently being researched: “It could be due to common risk factors, such as genetic factors, that might predispose women to both pregnancy loss and stroke events, it could also be due to endocrine dysfunction.”

In a general sense, strokes occur when the brain becomes starved of oxygen, either via a blocked (ischemic), or burst (hemorrhagic) blood vessel, commonly causing a drop on one side of the face, difficulty talking and mobility problems. Strokes can sometimes affect pregnant women as their blood changes and becomes more likely to clot.

Though the exact relationship between pregnancy problems and strokes is not understood, Dr. Mishra explained that this research had immediate application in identifying women at a higher risk of stroke, saying: “Given that in most cases the stroke occurred at least a decade after pregnancy loss, the knowledge that a woman is at a higher risk of stroke is an opportunity to monitor her health and for her to make lifestyle changes that can help prevent stroke.

“These include stopping smoking, being physically active, and having a healthy diet.”

What is a stroke?

A stroke occurs when the blood supply to part of the brain is cut off, causing a brain injury, disability or death as brain cells begin to die.

The life-threatening medical condition requires urgent treatment, as the sooner a person receives treatment, the less damage is likely to happen.

Treatment can include medication or even surgery. Survivors are often left with long-term problems caused by injury to their brain.

What are the symptoms?

The main symptoms can be remembered with the word ‘fast’, the NHS says.

Face – the face may have dropped on one side or the person may not be able to smile
Arms – the person may not be able to lift both arms and keep them there due to weakness or numbness
Speech – their speech may be slurred or garbled, or they may not be able to talk at all
Time – dial 999 immediately if you notice any of these signs or symptoms
What are the causes?

The two main causes are ischaemic (the blood supply is stopped because of a blood clot) and haemorrhagic (a weakened blood vessel supplying the brain bursts).

The NHS says 85 per cent of all cases are ischaemic.

A ‘mini-stroke’, known as a transient ischaemic attack, occurs when the blood supply to the brain is temporarily interrupted. It also requires immediate treatment.

How to prevent a stroke?

Conditions that can increase the risk of having a stroke include high blood pressure, high cholesterol, atrial fibrillation and diabetes.

People can significantly reduce their risk by leading a healthy lifestyle.

The NHS suggests eating a healthy diet, exercising regularly, drinking alcohol in moderation and not smoking.