Risk for Pregnancy-Related Stroke Higher in Black Women

Pregnant African American woman holding her stomach in hospital
For both delivery and postpartum stroke, black women were found to be at an increased risk compared with white women.

The risk for pregnancy-related stroke is higher among black women than white women, according to research presented at the American Stroke Association’s 2019 International Stroke Conference, held February 6-8, 2019 in Honolulu, Hawaii.

Researchers led by Maria Daniela Zambrano, MD, from Columbia University in New York, sought to determine whether stroke risk differs by race during and after delivery. The team utilized records from the Nationwide Inpatient Sample of pregnant women between the ages of 15 to 54 years; these records comprised approximately 68 million delivery hospitalizations and 1.1 million post-delivery hospitalizations.  

Of the delivery hospitalizations, 8241 patients were diagnosed with stroke during delivery. Among those hospitalized after delivery, 11,073 women were diagnosed with stroke. Compared with white women, black women were at a 64% greater risk for stroke during delivery and at a 66% greater risk for stroke in the postpartum period.

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Compared with white women, black and Hispanic women with pregnancy-related complications, such as preeclampsia, were twice as likely to have a stroke during delivery. Hispanic women, however, did not have an increased risk for stroke-related hospitalizations after delivery compared with white women.

According to the authors, stroke risk can be reduced with lifestyle changes, controlled blood pressure, cholesterol, weight, and diabetes, healthy eating, smoking cessation, and increased physical activity.

“We have to identify our obstetric patients at higher risk of cerebrovascular complications and develop an individualized prenatal care plan after considering all their predisposing factors including race,” Dr Zambrano said in a statement.


Zambrano MD, Friedman AM, Boehme AK, Huang Y, Miller E. Pregnancy-related stroke more common among black women. Presented at: 2019 International Stroke Conference. February 6-8, 2019; Honolulu, HI. Poster WP354.