Adverse Pregnancy Outcomes and Risk for Stroke Study Date and Author Total No. of Subjects Study Design Pregnancy Outcome Cerebrovascular Outcome Follow-up, y HR or OR for Outcome (95% CI) Mannist et al, cohort study Gestational hypertension Ischemic cerebrovascular disease Bonamy et al, cohort study Preterm birth; SGA Cerebrovascular events (infarction, hemorrhage, subarachnoid hemorrhage, TIA, other stroke) Preterm birth 2.41 (1.4 4.17); SGA birth 1.68 (1.46 2.06); preterm and SGA birth Irgens et al, 2001175 cohort study Preeclampsia Stroke mortality Term preeclampsia 0.98 (0.5 1.91); preterm preeclampsia* 5.08 Wilson et al, 2003170 cohort study Ray et al, 2005176 cohort study Maternal placental syndrome Funai et al, 2005177 cohort study Kestenbaum et al, study Preeclampsia Cerebrovascular disease 2.53 (1.70 3.77) Lykke et al, 2009179 cohort Gestational hypertension, mild preeclampsia, severe preeclampsia Stroke 12.9 14.6 Gestational hypertension 1.58 CI indicates confidence interval; HR, hazard ratio; OR, odds ratio; SGA, small for gestational age; and TIA, transient ischemic attack. *Defined as preeclampsia between 16 and 36 weeks. such as methyldopa, labetalol, and nifedipine, with consideration of maternal and fetal side effects (Class I; Level of Evidence A). 2. Consideration may be given to treatment of moder- ate hypertension in pregnancy with safe and effective antihypertensive medications, given the evidence for possibly increased stroke risk at currently defined systolic and diastolic BP cutoffs, as well as evidence for decreased risk for the development of severe hypertension with treatment (although maternal- fetal risk-benefit ratios have not been established) (Class IIa; Level of Evidence B). 3. Atenolol, angiotensin receptor blockers, and direct renin inhibitors are contraindicated in pregnancy and should not be used (Class III; Level of Evidence C). 4. 