Adnan Qureshi, MD, on including a stroke, neurology specialist to manage elevated risks in pregnancy

While the elevated risk of stroke during pregnancy has been recognized for years, it has rarely translated into a concrete clinical action plan. Following his analysis of 220,479 pregnancies presented at the American Stroke Association (ASA) International Stroke Conference, Adnan I. Qureshi, MD, Professor of Neurology, University of Missouri; founder, Zeenat Qureshi Stroke Institutes, is calling for the potential expansion of the multidisciplinary team to include neurological or stroke expertise.

“I think that clearly there is a need to expand this multidisciplinary team that is involved, and involving a stroke specialist as part of that multidisciplinary team is something that is a true derivation of the results that we saw,” Qureshi told Contemporary OB/GYN in the video above. “Obviously, a history of a previous ischemic stroke does increase your risk of having an ischemic stroke during pregnancy and in the early postpartum period.”

The data presented at the ASA conference backs up that claim, as Qureshi reported that women with a prior history of ischemic stroke face 2.37 times higher odds of a recurrent event during pregnancy or the 6-week postpartum window.^1,2

Monitoring physiological triggers

A critical component of this integrated care involves monitoring the unique physiological changes of pregnancy that exacerbate stroke risk. Qureshi noted that hypertensive disorders and increased coagulability are primary concerns that require vigilant oversight

“Monitoring for that is an important component in this particular high-risk group of women,” Qureshi stated. This specialized monitoring is especially vital for the 34.82% of women with prior stroke who experienced a new incident event in the study.

The "good news" of modifiable risk

Perhaps the most encouraging finding from the research is that these risks may be modifiable. The multivariate analysis indicated that while factors like obesity (OR 1.25) and previous myocardial infarction (OR 1.82) increase risk, medical intervention may offer protection.

“In our study, we found that women who were on aspirin or were treating blood pressure with medication seemed to have a lower risk of having a stroke,” Qureshi shared. This observation provides a hopeful outlook for high-risk patients and clinicians alike. “It actually opens the pathway for studying new medications that can mitigate and reduce the risk of having an ischemic stroke, particularly in this category,” Qureshi concluded.

References:

1. 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.
2. Fitch J. Adnan Qureshi, MD: Higher recurring stroke risk in pregnancy. Contemporary OB/GYN. Published March 13, 2026. Accessed March 16, 2026. https://www.contemporaryobgyn.net/view/adnan-qureshi-md-higher-recurring-stroke-risk-in-pregnancy