A new study from UT Health San Antonio and the University of Galway suggests that women who have three or more live births may have a lower risk of stroke and hidden vascular brain damage. The findings, published in the Journal of the American Heart Association on April 7, 2026, could help doctors better predict stroke risk in women.
The Research
Scientists analyzed data from the Framingham Heart Study, a long-running observational study in Framingham, Massachusetts. They followed 1,882 women, average age 61, who were stroke-free at the start, for a median of 18 years. The team tracked reproductive factors—including number of live births, age at menopause, and hormone therapy use—and recorded strokes and MRI markers of vascular brain injury.
Over the follow-up period, 126 women had strokes. The researchers found that women with three or more live births had a significantly lower risk of stroke from all causes compared to those with fewer children. They also had fewer covert brain infarcts (small lesions from reduced blood flow) and lower volumes of white matter hyperintensity, both signs of vascular damage. The results held even after adjusting for high blood pressure and cholesterol.
“Our findings would suggest that reproductive factors—for example, number of live births—may be an additional factor to consider when assessing stroke risk in women,” said Sudha Seshadri, MD, senior author and director of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio. Unexpectedly, other factors like hormone replacement therapy or estradiol levels did not show the same protective association in this cohort.
Why It Matters
Stroke affects women disproportionately—57% of all strokes in the U.S. occur in women. This study highlights that a woman’s reproductive history, specifically the number of live births, may be a unique and simple predictor of future stroke risk. For researchers, it suggests that pregnancy-related hormonal and vascular changes may have long-term protective effects on the brain. For women, knowing this can help in discussions with their doctors about personal stroke risk.
What You Can Do
While you can’t change your number of live births, you can manage other stroke risk factors: maintain healthy blood pressure, eat a balanced diet, exercise regularly, avoid smoking, and limit alcohol. Talk to your doctor about your reproductive history and how it fits into your overall cardiovascular risk profile.
Source: Neuroscience News
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