Functional recovery after maternal ischemic stroke may be commonly favourable

1. Most women experience good functional recovery after maternal ischemic stroke.

2. Long-term mortality and neurologic morbidity remain significantly higher than in women without pregnancy-related stroke.

3. Vocational outcomes are adversely affected, with higher rates of disability pension use among survivors.

Evidence Rating Level: 2 (Good)

Maternal ischemic stroke is a rare but serious complication of pregnancy and the postpartum period, yet its long-term prognosis has been insufficiently characterized. This nationwide retrospective cohort study examined long-term mortality, morbidity, functional recovery, and vocational outcomes among women with a history of maternal ischemic stroke in Finland. Using national health registers, the authors identified women who experienced ischemic stroke during pregnancy or within the postpartum period between 1987 and 2016 and compared them with age-matched women without pregnancy-related stroke. Mortality and long-term morbidity outcomes were assessed using hospital discharge diagnoses, medication data, and cause-of-death registries. Functional recovery was evaluated using modified Rankin Scale scores, and vocational status was assessed through employment and disability pension records. Women with maternal ischemic stroke had significantly higher long-term mortality and increased rates of neurologic and cardiovascular morbidity compared with controls. Despite this, most survivors achieved good functional recovery, with the majority demonstrating favorable functional outcomes. However, women with prior maternal ischemic stroke were more likely to experience persistent neurologic deficits and were less likely to be fully employed, with higher rates of disability pension use. The authors conclude that although functional recovery after maternal ischemic stroke is often favorable, affected women face increased long-term mortality, morbidity, and vocational challenges, underscoring the need for long-term follow-up and multidisciplinary support.

Click here to read this study in Neurology

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