Adnan Qureshi, MD, highlights a "bidirectional" awareness gap for recurring stroke risk in pregnancy

While clinical intuition has long suggested an association between prior stroke and pregnancy complications, objective data has remained sparse due to the rarity of these events. Following his presentation at the American Stroke Association International Stroke Conference, Adnan I. Qureshi, MD, Professor of neurology, University of Missouri; Founder, Zeenat Qureshi Stroke Institutes, discussed how new large-scale data from over 220,000 pregnancies provides the statistical power necessary to move from a "sense" of risk to a concrete action plan.

The advantage of a 220,479-pregnancy cohort

Previous research into stroke during pregnancy has often been limited to single-center or small multicenter studies, which Qureshi noted lack the design advantage to reach conclusive answers. By analyzing a massive dataset of 220,479 pregnancies, his team established that women with a history of previous ischemic stroke face 2.37 times higher odds of a recurrent event (P < 0.0001).

“Unless you have enough women who are pregnant being studied together, you just do not have the necessary statistical power,” Qureshi explained. This robust evidence is critical given the incident event rate of 34.82% found in high-risk patients compared to 0.34% in those without a prior history. This objective backing now allows clinicians to quantify risks more precisely when counseling patients on whether to move forward with a pregnancy.

Bridging the bidirectional awareness gap

Qureshi identified a "bidirectional" lack of awareness that spans both patients and the medical community. Without hard data, the elevated risk of stroke during pregnancy and the six-week postpartum period has often been overlooked in routine clinical practice.

“There is a lack of awareness among young people, but there is also a lack of awareness among medical professionals,” Qureshi stated. He argued that the study's findings should prompt a fundamental shift in high-risk pregnancy management, specifically calling for the inclusion of stroke history in standard care pathways. This includes localizing care at specialized centers geared toward high-risk management and integrating stroke specialists or neurologists into the multidisciplinary obstetric team.

Reference:

Qureshi A. Two Folds Higher Odds of Ischemic Stroke during Pregnancy and Post-partum Period in Women with a History of Ischemic Stroke. Abstract. Presented at: International Stroke Conference. February 5-7, 2026. Los Angeles, California.