The postpartum experience is can be a stressful and even scary time when it comes to your health. Your body is dealing with the aftermath of childbirth and all the physical and mental challenges that come with it, including postpartum depression and anxiety. Pregnancy-related stroke is considered a rare health outcome, but it’s another anxiety-inducing postpartum possibility. According to New York Presbyterian Hospital, the risk of a pregnancy-related stroke is “most significant” in the two weeks just after childbirth, but can remain high for 12 or more weeks after delivery. It doesn’t help that many symptoms of stroke (like headaches, dizziness, or tingling arms) can easily be mistaken for issues related to pregnancy or having a newborn, as the CDC points out.
Thanks to a large new study, doctors are now learning that some people are more likely to experience a stroke after pregnancy — and it has to do with infertility treatment. According to the study, published today on JAMA Network, women who undergo infertility treatment before becoming pregnant are more likely to have a stroke in the year following childbirth compared to women who conceived naturally. The study found that stroke risk was evident “as early as 30 days after delivery” and increased throughout the first 12 months after childbirth.
It’s important to note that the overall numbers were still pretty small, underscoring the rare nature of postpartum and pregnancy-related strokes. There were just 37 stroke hospitalizations for every 100,000 women who underwent infertility treatment, compared to 29 hospitalizations for every 100,000 women who conceived without infertility treatment. This also comes after previous studies turned up mixed results, including a study published earlier this month that found no association between infertility treatments and increased risk of stroke.
The current study, however, has been billed as the largest of its kind, consisting of health outcome data from over 31 million patients who had hospital deliveries in 28 states, from 2010 to 2018. (In comparison, the earlier study analyzed data from about 2.5 million patients in Denmark, Finland, Norway, and Sweden.) The current study also focuses on the US, which has by far the highest maternal mortality rate among high-income countries — making these findings all the more important for both doctors and patients.
The infertility treatments considered by the researchers included intrauterine insemination, assisted reproductive technology, fertility preservation procedures (like egg freezing), and surrogacy. Ultimately, the study found that women who underwent these kinds of treatments had twice as high a risk of having a hemorrhagic stroke (bleeding in the brain) and a 55 percent higher risk of an ischemic stroke (interruption in blood supply to the brain) versus women who conceived naturally.
So what’s driving the possible link? The study identified a few potential explanations. For one thing, infertility treatment “may contribute” to some blood vessel-related issues, like preeclampsia and placental abruption, which could themselves increase stroke risk, the study notes. There’s also the fact that infertility treatments can cause physiological changes to the body that increase the risk of stroke. Estrogen supplements, for example, can increase the possibility of blood clotting, which is a big risk factor for stroke, as lead researcher Cande V. Ananth, chief of epidemiology and biostatistics at the Robert Wood Johnson Medical School, pointed out in an interview with the New York Times.
Finally, the researchers suggest that people getting infertility treatment may simply have more pre-existing health factors that could put them at risk for stroke.
Ultimately, the study concluded that the why of infertility and increased stroke risk was still unknown — which isn’t the most comforting thing if you’re using or have used infertility treatments to get pregnant and are wondering if you’re at risk. The best thing to do? Talk to your doctor about any concerns you may have and familiarize yourself with the risks. It’s also a good idea to remind yourself of a few common signs of a stroke. According to the CDC, look out for symptoms that come on suddenly, such as numbness or weakness in the face, arm, or leg; confusion, trouble speaking, or difficulty understanding speech; trouble seeing; trouble walking; dizziness; or severe headache.
Postpartum stroke is still considered a rare event, infertility treatment or no. But this potential link may be an important finding for doctors and patients alike, especially if you’re considering your options for getting pregnant.
Before you go, check out these celebrities who opened up about life with a rare or chronic illnesses: