{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T09:56:00Z","timestamp":1793786160390,"version":"4.6.1"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"33","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"the National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL139536"],"award-info":[{"award-number":["R01HL139536"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"the Swedish Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"the Swedish Heart-Lung Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Avtal om L\u00e4karutbildning och Forskning"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>The lifelong risk of stroke following adverse pregnancy outcomes, and potential causality, are unknown. This study examined five major adverse pregnancy outcomes and long-term risk of stroke in a large population-based cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A national cohort study was conducted of all 2 201 393 women with a singleton delivery in Sweden during 1973\u20132015, followed up for stroke through 2018. Cox regression was used to determine hazard ratios (HRs) for stroke associated with preterm delivery, small for gestational age, preeclampsia, other hypertensive disorders, and gestational diabetes, adjusting for other maternal factors. Co-sibling analyses assessed for potential confounding by shared familial (genetic or environmental) factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 48 million person-years of follow-up, 667 774 (30%) women experienced an adverse pregnancy outcome and 35 824 (1.6%) women were diagnosed with stroke. All five adverse pregnancy outcomes were independently associated with long-term increased risks of stroke. With up to 46 years of follow-up, adjusted HRs for stroke associated with specific adverse pregnancy outcomes were: gestational diabetes, 1.86 (95% confidence interval 1.69\u20132.04); other hypertensive disorders, 1.82 (1.67\u20131.98); preterm delivery, 1.40 (1.36\u20131.45); preeclampsia, 1.36 (1.31\u20131.41); and small for gestational age, 1.26 (1.22\u20131.29). All HRs remained significantly elevated (1.2- to 2.5-fold) even 30\u201346 years after delivery. These findings were only partially explained by shared familial factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a large national cohort, women with any of five adverse pregnancy outcomes had increased risks of stroke up to 46 years after delivery. Women with adverse pregnancy outcomes need early preventive actions and long-term follow-up to reduce their lifelong risk of stroke.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf366","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T13:08:49Z","timestamp":1750943329000},"page":"3290-3300","source":"Crossref","is-referenced-by-count":20,"title":["Adverse pregnancy outcomes and long-term risk of stroke: a Swedish nationwide co-sibling study"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2990-1166","authenticated-orcid":false,"given":"Casey","family":"Crump","sequence":"first","affiliation":[{"name":"Departments of Family and Community Medicine and of Epidemiology, The University of Texas Health Science Center , 1133 John Freeman Boulevard, JJL 300, Houston, TX 77030 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-5015","authenticated-orcid":false,"given":"Jan","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Department of Clinical Sciences, Lund University , Malm\u00f6 ,","place":["Sweden"]},{"name":"University Clinic Primary Care Sk\u00e5ne , Region Sk\u00e5ne ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8031-279X","authenticated-orcid":false,"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Department of Clinical Sciences, Lund University , Malm\u00f6 ,","place":["Sweden"]},{"name":"University Clinic Primary Care Sk\u00e5ne , Region Sk\u00e5ne ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"2025101322571547500_ehaf366-B1","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","article-title":"Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"392","author":"Global Burden of Disease Causes of Death Collaborators","year":"2018","journal-title":"Lancet"},{"key":"2025101322571547500_ehaf366-B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.tcm.2015.04.010","article-title":"Burden of stroke in women","volume":"26","author":"Lundberg","year":"2016","journal-title":"Trends Cardiovasc Med"},{"key":"2025101322571547500_ehaf366-B3","doi-asserted-by":"publisher","first-page":"e347","DOI":"10.1161\/CIR.0000000000001209","article-title":"2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association","volume":"149","author":"Martin","year":"2024","journal-title":"Circulation"},{"key":"2025101322571547500_ehaf366-B4","doi-asserted-by":"publisher","first-page":"2541","DOI":"10.1161\/STROKEAHA.107.485482","article-title":"Paul coverdell national acute stroke registry Michigan prototype investigators. 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