Intrauterine Stroke Overview

Intrauterine strokes are strokes that affect babies before they are born or shortly afterward. Some babies who have this type of stroke develop symptoms right away, and for some babies, the effects only become obvious later as a child develops. Many children recover and do well in life, but strokes are areas of brain damage due to a deficiency in blood supply—and they can cause permanent brain medical and neurological problems.

Strokes in babies can cause overwhelming anxiety and uncertainty for expectant and new parents. In recent years, science has made it easier for healthcare providers to find these strokes in babies, while research on prevention and treatment has been moving forward.

This article looks at what parents should know about strokes affecting babies, including how to reduce your baby’s risk of stroke and what you can do if one occurs.

Intrauterine Stroke

Woman getting an ultrasound

 Noah Clayton / Getty Images

The symptoms of intrauterine stroke are not always obvious. Advances in technology mean that healthcare providers can sometimes diagnose these types of strokes while the fetus is still developing.

Some pregnancies carry a higher-than-average risk that the baby may have a stroke in the womb. Mothers with blood-clotting conditions are at a greater risk. Blood-clotting disorders can be found using specific blood tests.

Other maternal conditions may increase a baby's stroke risk:

  • Preeclampsia (high blood pressure during pregnancy)
  • Diabetes and gestational diabetes
  • Maternal heart disease
  • Infections
  • Drug abuse
  • Placenta problems

Treatment of these disorders during pregnancy requires a complex decision-making process. This is why it is important for expectant mothers to have early and consistent prenatal care.

Pregnant mothers should also seek urgent care for health problems that occur during pregnancy, such as trauma, fevers, and seizures—these problems can affect the baby’s blood supply.

There is more than one kind of intrauterine stroke that can affect the developing fetus.

  • They are generally called prenatal if they happen during the first half of pregnancy.
  • A perinatal stroke happens in the latter half of pregnancy, or while a baby is a newborn. Perinatal stroke is the cause in most cases of hemiparetic cerebral palsy (i.e., cerebral palsy that affects one side of the body), one of the medical issues that may arise because of these strokes.

Perinatal Stroke

Perinatal strokes may happen in roughly 37 to 67 of every 100,000 births. They happen later in pregnancy, beginning at about 20 or 22 weeks of development, or in the first month after a baby is born. In many cases, these strokes affect babies who were born at full term.

While there may be no symptoms before birth, there are many cases in which the baby's brain injury from a stroke causes symptoms.

In infants, you should watch for:

  • Seizures
  • Weakness or diminished movement of one arm, leg, or another part of the body
  • Trouble eating
  • Trouble breathing
  • Delays in developmental milestones

Keep in mind that most babies will be fine, and even many of those who had strokes at or before birth will recover with high levels of function. But perinatal strokes do carry risks that can affect a child across a lifetime, including cerebral palsy and seizure disorders.

Consequences for the Baby

There is a range of possible outcomes after an intrauterine stroke. Some children will have no effects or minimal effects, and some may have severe and long-lasting developmental problems.

The outcome depends on factors that include:

  • The type of stroke
  • The size of the stroke
  • The brain region that was affected
  • The developmental stage of the growing baby

Some babies who have a stroke before they are born may go on to have learning problems, physical limitations, behavioral problems, or seizures.

Some children will develop hydrocephalus (fluid around the brain). This may require a procedure to remove the fluid, or long-term treatment, such as shunt placement.

What You Can Do

If you have a bleeding or blood-clotting problem, or if you have ever had blood clots it is important to let your healthcare provider know if you’re planning to become pregnant or as soon as you find out that you are pregnant.

And if you have a history of preeclampsia, gestational diabetes, or miscarriages, this can increase the risk of prenatal or perinatal strokes. It is important to work with your healthcare provider during subsequent pregnancies to prevent complications.

Taking Care of Your Baby

If you learn that your baby has had a stroke, you will be referred to a pediatric neurologist who specializes in such cases. A detailed assessment during infancy can identify problems early on. This can help with diagnosis, answer some of the questions you have, and serve as the beginning of your action plan.

Early evaluation of vision, speech, and hearing can identify any deficits and help determine what corrective measures will help. Therapy may be directed to help develop good balance and motor skills, as well as emotional and learning skills.

Summary

Strokes that happen to babies before they are born, or immediately after, can cause developmental problems for a growing child. Prevention begins with good maternal care, especially in cases where a mother’s medical history may increase the risk of stroke for the baby.

Diagnosis of an infantile or prenatal stroke involves imaging tests. Identifying the effects of a stroke at this young age relies on a neurological examination and testing developmental milestones. Sometimes therapies, including physical therapy or speech therapy, can help improve outcomes. For some children, anti-seizure medication is necessary to control and prevent seizures caused by an infantile stroke.

A Word From Verywell

Without question, it is stressful to learn that your baby has had a life-changing stroke while still so young. But there is good reason to hope for resilience in the brain of a developing young child. Many children who are born after an intrauterine stroke show the same promise as others, and your healthcare provider can help you get the best results.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Nemours Foundation. Strokes (for parents).

  2. Kirton A, Metzler MJ, Craig BT, et al. Perinatal stroke: mapping and modulating developmental plasticityNat Rev Neurol. 2021;17(7):415-432. doi:10.1038/s41582-021-00503-x

  3. Fluss J, Dinomais M, Chabrier S. Perinatal stroke syndromes: Similarities and diversities in aetiology, outcome and managementEur J Paediatr Neurol. 2019;23(3):368-383. doi:10.1016/j.ejpn.2019.02.013

  4. Dunbar M, Kirton A. Perinatal stroke: mechanisms, management, and outcomes of early cerebrovascular brain injury. Lancet Child Adolesc Health. 2018;2(9):666-676. doi:10.1016/S2352-4642(18)30173-1

Additional Reading

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.