Intrauterine Stroke Overview

Intrauterine strokes can affect babies before they are born, or shortly afterward. Some babies who have these strokes have symptoms right away, while the injury to others may only become obvious later as a child develops. Many children recover and do well in life, but these strokes often cause permanent brain injuries and medical conditions.

Strokes in babies can cause overwhelming anxiety and uncertainty for expectant and new parents. In recent years, science has made it easier for doctors to find these "invisible" 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 doctors can sometimes diagnose these strokes while the fetus is still developing. Still, there may be no sign of a stroke and a mother likely does not know.

This is why it is important for expectant mothers to have good prenatal care. They should seek urgent care for health problems such as trauma, fevers, and seizures.

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. Many of these blood-clotting disorders can be found using blood tests specifically for that.

Other conditions in the mother that may increase a baby's stroke risk include:

  • preeclampsia (high blood pressure during pregnancy)
  • diabetes
  • infections
  • drug abuse
  • placenta problems

To treat some of these disorders during pregnancy requires a complex decision-making process. In the same way, how to manage a stroke that affects a baby prior to birth is not always straightforward.

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 most cases, these strokes occur in babies who were born at full term.

This differs from intrauterine stroke because it doesn't just happen during pregnancy. One research author, writing for the American Heart Association journal Stroke, called the week surrounding a baby's birth "the most focused lifetime risk for stroke."

While there may be no symptoms before birth, there are many cases in which the baby's brain injury from stroke is immediately clear — or soon to be revealed. These symptoms can be easy to miss and may seem like typical newborn patterns. In infants, you should watch for:

  • seizures in one arm, leg, or other part of the body
  • trouble eating
  • trouble breathing
  • delays in developmental milestones

Clearly, 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.

Recap

There is more than one kind of intrauterine stroke that affects the developing fetus. They are generally called prenatal if they happen in the first half of pregnancy. A perinatal stroke happens in the latter half of pregnancy, or to the newborn baby. Perinatal stroke is the cause in most cases of cerebral palsy, one of the medical issues that may arise because of these strokes.

Consequences for the Baby

There is a range of possible outcomes after an intrauterine stroke. They depend 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

The resulting problems may be mild, or they may be more serious. Some babies who have a stroke before they are born may go on to have seizures or cerebral palsy. Others may have weakness in one arm or leg, or develop learning problems later on.

Strokes that happen before birth are not rare, but the ability to detect them is still fairly recent. There were likely many cases in the past that were missed. Even now, some parents never knew at birth and only start to see problems in later weeks and months.

What You Can Do

If you have a bleeding or blood-clotting problem, it is important to let your doctor know if you're planning to become pregnant or as soon as you find out that you are. Similarly, if you have a history of miscarriages or if you have ever had blood clots, it is important to work with your doctor to find any problem that you do not know about.

It's also a good idea to know the other risk factors, which may be known because of your own health conditions or entirely new because they are related to pregnancy. Preeclampsia, for example, only happens in pregnancy. Diabetes can be gestational too, but it also may be an underlying history that your doctor needs to know about.

Taking Care of Your Baby

If you learn there was a stroke, either during your pregnancy or after your baby is born, make sure your family doctor is ready to care for the child. You may wish to consider a pediatric neurologist who specializes in such cases because a detailed assessment in 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.

It's essential to maintain the relationship and keep careful watch over the baby's development. Early therapy to help develop good balance and motor skills, as well as emotional and learning skills, can boost recovery. Early evaluation of vision, speech, and hearing can help identify any gaps and what corrective measures will help.

Sometimes, treatment can help improve the outcome, while in other situations, the medical plan begins with careful "wait and see" monitoring. Drugs to control seizures, for example, will help to prevent injury and treat what may be a lifelong disorder.

Summary

Strokes that happen to babies before they are born, or immediately after, are not all that unusual. What's different now is our ability to know about them, and begin taking steps to prevent as many as harms as possible. That begins with good maternal care, especially in cases where a mother's own medical history may point to a stroke risk for the baby.

But it doesn't end there, and these babies may need more help than others. Watching them closely as they begin to grow is an important part of protecting a baby's health and their future.

A Word From Verywell

Without question, there are few things more upsetting than the news that your long-anticipated baby has had a life-changing seizure 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 doctor can help you get the best results.

Was this page helpful?
Article 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). Reviewed December 2018.

  2. Fluss J, Dinomais M, Chabrier S. Perinatal stroke syndromes: Similarities and diversities in aetiology, outcome and managementEuropean Journal of Paediatric Neurology. 2019;23(3):368-383. doi: 10.1016/j.ejpn.2019.02.013

  3. 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

Additional Reading
  • Li C, Miao JK, Xu Y, et al. Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis. Eur J Neurol. 2017;24(8):1006-1015.