Study Highlight:

  • Women diagnosed with a bladder infection, pneumonia or sepsis during delivery were more than five times likely than uninfected women to be readmitted to the hospital for stroke within one month.

Embargoed until 4 a.m. CT/5 a.m. ET, Wednesday, Jan. 30, 2019

DALLAS, Jan. 30, 2019 — Women diagnosed with an infection during delivery had a much greater risk of stroke after delivery, according to preliminary research to be presented in Honolulu at the American Stroke Association’s International Stroke Conference 2019, a world premier meeting for researchers and clinicians dedicated to the science and treatment of cerebrovascular disease.

“Even though it is rare, maternal stroke has been increasing in the United States,” said Eliza C. Miller, M.D., study lead author and assistant professor of neurology in the Division of Stroke and Cerebrovascular Disease at Columbia University Irving Medical Center in New York. “Women who have infections at the time of delivery should be counseled about the signs and symptoms of stroke, such as severe headache, vision changes, speech difficulty or sudden weakness, and the need to seek immediate medical attention if they experience these symptoms.”

Researchers examined more than 3.5 million delivery hospitalizations from the 2013 Healthcare Cost and Utilization Project National Readmissions Database, which compiles information on hospital care throughout the United States. Out of 79,656 women who were readmitted to the hospital within one month after delivery, 225 were readmitted for stroke.

Researchers found:

  • A strong relationship between infections, including bladder infections, pneumonia, and sepsis (a serious blood infection) during hospitalization for delivery and stroke within the following month.

  • Women with an infection during delivery hospitalization were more than five times as likely to be readmitted to the hospital for stroke.

  • Women readmitted for stroke were more than three times as likely to have had an infection during their delivery hospitalization, compared with women readmitted for other reasons.

  • The increased stroke risk occurred regardless of whether women had pregnancy-related .

“These results reflect the diversity of the United States and are widely generalizable to the U.S. population of women of childbearing age,” Miller said. “At the same time, the number of stroke readmissions was small, so it's important not to draw the conclusion that everyone who has an infection is going to have a stroke. The study shows an association but does not prove that the infection caused the stroke.”

Information on hospital care could not provide details about other potential stroke risks, researchers noted.

Earlier work by these researchers linked infections, especially of the bladder, to stroke risk during delivery hospitalization and among women with pregnancy-related high blood pressure, or preeclampsia. Since the majority of pregnancy-related strokes occur after delivery, often after women are sent home from the hospital, the current study focused on the period after delivery.

A stroke occurs when a blood vessel to the brain either becomes blocked by a blood clot or bursts, preventing blood and oxygen from reaching the brain. Without immediate treatment to restore blood flow, the affected part of the brain dies. In the United States, stroke is the fifth-leading cause of death and a primary cause of long-term disability. Women are at higher lifetime risk than men, and pregnancy is an additional risk factor.

Co-authors are Jessica Medina; Alexander M. Friedman, M.D.; Mitchell S. Elkind, M.D., M.S.; and Amelia K. Boehme, Ph.D.

The National Institutes of Health and the Louis V. Gerstner Jr. Foundation funded the study.

Note: Scientific presentation is 5:35 p.m. HT/10:35 p.m. ET, Wednesday, Feb. 6, 2019.

Additional Resources:

Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

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About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit StrokeAssociation.org. Follow us on Facebook and Twitter.

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