Although rare, stroke occurring during pregnancy and the postpartum period are devastating events for both mother and child as they are associated with increased risks of disability, miscarriage, pre-term birth, low birth weight, and mother’s death. Furthermore, stroke in pregnancy is generally increasing, probably due to advanced maternal age and associated vascular risk factors such as hypertension. Stroke secondary prevention medications are potentially teratogenic and can impact decisions about breastfeeding.

Because of the inability to carry out ethical randomized controlled trials in this cohort of patients, scarce reliable literature is available. In the majority of cases, the etiology of stroke during pregnancy is undetermined. A better knowledge of these events and their epidemiology should improve the prevention of pregnancy and postpartum-associated stroke and allow us to set standards for the care of these women.

Some degree of pregnancy-associated stroke is avoidable as it is linked to unscreened or uncontrolled cardiovascular risk factors such as hypertension or diabetes. The mismanagement of these risk factors during and after delivery also puts women at a higher risk of stroke. A history of pregnancy hypertensive disorders like pre-eclampsia or impaired glucose tolerance might have an important impact later in life on the risk of stroke in women that should be better documented and monitored.

There is a lack of published evidence about acute interventions during this phase and studies are necessary to pursue the evaluation of security and safety of endovascular and thrombolytic treatments during pregnancy and their impact on the continuation of the pregnancy, the delivery mode, and the health of both mother and child.

Finally, health social inequalities play an important role in the occurrence of stroke in pregnancy or postpartum. Further research is required to develop and implement health policy to reduce these inequalities and their impact on stroke risk in pregnant women or in postpartum. This is particularly relevant in the developing world where mortality in pregnancy and postpartum is higher.

In this light, our Research Topic welcomes the submission of any type of manuscript supported by the journal (including Original Research, Review, etc.) pertaining, but not limited to the following themes:
- Screening and management of vascular risk factors before and after pregnancy-related stroke
- Anticoagulants for stroke prevention during pregnancy and in the postpartum period and cardioembolic stroke
- Association between hypertensive disorders and stroke during pregnancy or postpartum
- Revascularization and thrombolysis of ischemic stroke during pregnancy and their outcomes
- Intracerebral hemorrhage in pregnancy and the postpartum phase: causes, management, and prevention
- Cerebral venous thrombosis during pregnancy and the postpartum
- Reversible cerebral vasoconstriction syndrome during pregnancy and the postpartum period
- Risk of stroke during subsequent pregnancies
- Short-, middle- and long-term outcomes of pregnancy-related strokes and their treatments on mother and child health: termination of pregnancy, gestational age, and mode of delivery
- Stroke and medically assisted procreation
- Stroke rehabilitation in pregnant women or in postpartum
- Health social inequalities and pregnancy-related stroke

Dr. Christine Kremer acts as Principal Investigator in clinical trials funded by AstraZeneca (on an antidote to reverse the anticoagulant effect of Factor Xa inhibitors) and Janssen (on Factor XIa inhibitors). The other Topic Editors declare no competing interests with regard to the Research Topic subject.

Impact

Frontiers in Stroke

Population Health and Risk Factors of Stroke

Acute Stroke and Interventional Therapies