Top Things to Know: Prevention and Treatment of Maternal Stroke in Pregnancy & Postpartum
Published: January 28, 2026
Prepared by Anne Leonard MPH, RN, National Senior Director Science and Medicine, American Heart Association
- Stroke accounts for 4-6% of maternal deaths in the U.S.
- Stroke remains a rare but life-threatening complication of pregnancy, with significant implications for both maternal and fetal health.
- Stroke is a serious and potentially devastating complication of pregnancy, affecting approximately 20 to 40 of every 100,000 pregnancies.
- Primary stroke prevention strategies include risk factor modification, aggressive hypertension management and prompt treatment of severe hypertension in pregnancy and postpartum, and antithrombotic therapy in some high-risk groups.
- Pregnancy should not delay evidence-based treatments for acute stroke as a medical emergency.
- Identified risk factors for pregnancy-associated stroke include HDP, migraine, infections, heart or cerebrovascular disease, and hematological conditions (e.g. thrombophilia, antiphospholipid syndrome, sickle cell disease).
- Current stroke prevention and treatment guidelines offer limited guidance for managing stroke in pregnant and postpartum patients. The gap is largely due to exclusion of pregnant and lactating individuals from all major stroke trials.
- This statement discusses both the physiology and pathophysiology of pregnancy. Included within is hypertension disorders of pregnancy (HDPs).
- Both primary and secondary prevention suggestions are addressed in this paper for many areas related to pregnancy issues.
- This important paper discusses treatment of acute stroke in pregnancy and postpartum includes delivery considerations, anesthesia considerations, and post-partum management of this patient group. Stroke recovery in the pregnant and post-partum woman are addressed including contraception, psychological issues, sexual dysfunction and sleep issues.
Citation
Miller EC, Bello NA, Chen PR, Leffert L, Leppert M, Madsen T, Skeels K, Tita A, Valdes E, Shields A; on behalf of the American Heart Association Women’s Health Science Committee of the Council on Clinical Cardiology and Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Lifelong Congenital Heart Disease and Heart Health in the Young. Prevention and treatment of maternal stroke in pregnancy and postpartum: a scientific statement from the American Heart Association. Stroke. Published online January 28, 2026. doi: 10.1161/STR.0000000000000514