Long-Term Recovery, Morbidity, and Mortality After Maternal Ischemic Stroke.

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Long-term prognosis following maternal ischemic stroke (IS) is not well-understood.
• Previous studies have not adequately compared outcomes between women with and without pregnancy-related strokes.

Purpose of the Study:

• To investigate if mortality and long-term morbidity are more frequent in women with prior maternal IS compared to controls.
• To assess functional outcomes and vocational status in maternal IS survivors.

Main Methods:

• Retrospective nationwide cohort study in Finland (1987-2016).
• Maternal IS patients identified from national registers, compared with 3:1 matched controls.
• Mortality, cardiovascular diseases, depression, and vocational status tracked using national registers; functional outcomes assessed via modified Rankin Scale (mRS).

Main Results:

• Maternal IS patients (n=97) showed higher overall mortality (8.3% vs 1.8%) and significantly more cardiovascular events, cardiac diseases, and depression compared to controls (n=265).
• Despite good functional outcomes (mRS 0-2) in 92.1% of survivors, employment was rarer and retirement more common in the maternal IS group.
• Recurrent strokes occurred in 5.6% of maternal IS patients.

Conclusions:

• Maternal IS is associated with a substantial long-term cardiovascular burden and reduced vocational participation.
• While functional outcomes are often good, comprehensive management of vascular risk factors and targeted rehabilitation are essential for optimizing long-term prognosis in these young patients.