They found the OR for the effect of lifestyle interventions on the risk for CVD after a preeclamptic pregnancy to be 0.91 (interquartile range, 0.87 0.96), which suggests that these interventions could reduce the risk of stroke in this population. Although one limitation of this research was the extrapolation of lifestyle interven- tions performed in older populations to a younger population of women 1 to 30 years after preeclampsia, prospective stud- ies are warranted on the basis of the implication that lifestyle interventions in these women might be effective.189 Preeclampsia and Pregnancy Outcomes: Summary and Gaps Hypertensive disorders of pregnancy and other complications (preterm birth, small size for gestational age, and first- trimester bleeding) are associated with increased risk of stroke during pregnancy, immediately after delivery, and years after deliv- ery. This risk has been quantified in large retrospective studies, mostly in northern European populations. Prospective studies on the pathophysiology underlying the association between hypertensive disorders of pregnancy and stroke, especially in diverse populations, are needed, because it is not known whether prepregnancy risk factors or pregnancy-associated factors predispose these women to subsequent risk of stroke. Research also suggests that clinicians are not aware of the asso- ciation between adverse pregnancy outcomes and CVD and stroke, which suggests a need for better clinician and patient Although a limited number of studies have exam- ined cardiovascular and stroke risk factors and documented increased risk for events long-term in women with these dis- orders, there are no prospective randomized controlled trials assessing interventions to reduce stroke risk in this population with clear risk factors (preeclampsia, gestational diabetes). 