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Number of pregnancies and risk for stroke and stroke subtypes
A I Qureshi1, W H Giles, J B Croft
1Department of Neurology, Emory University School of Medicine, Atlanta, Ga, USA.
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.