Insight
Stroke during pregnancy linked to long-term heart and mental health risks

Stroke during pregnancy and postpartum is associated with higher long-term risks of cardiovascular events and depression, a study has found.
Researchers from the University of Helsinki in Finland identified 97 female participants in Finnish healthcare registries who had an ischaemic stroke (the most common type of stroke, which occurs when a clot or blockage reduces blood flow to the brain, depriving it of oxygen and nutrients) during pregnancy or postpartum, up to three months after pregnancy.
They were matched to 280 female participants who did not have a stroke.
Researchers tracked the health of each person through registries and medical records for an average of 12 years, noting which participants later had cardiovascular events such as heart attack, stroke and heart disease or depression.
Of participants with an initial stroke, six per cent had a second stroke and seven per cent had a major cardiovascular event such as heart attack compared to zero per cent of those who were stroke-free at the start of the study.
Anna Richardt, study author from the University of Helsinki, said: “Having a stroke during pregnancy or postpartum is rare but several studies have shown it is on the rise.
“Our study sought to better understand what happens to women after a stroke during pregnancy and postpartum and found an increased risk of cardiac diseases and depression, as well as lower odds of being employed later.”
Researchers also found among participants with stroke, nine per cent had cardiac disease, including atrial fibrillation (an irregular heartbeat) or congestive heart failure (when the heart cannot pump blood effectively), compared to one per cent of those who did not have stroke.
After adjusting for age, participants with stroke had a nearly nine times greater odds of having cardiac disease.
Of participants with stroke, 19 per cent had depression compared to six per cent of those without stroke. After adjusting for age, those with stroke had nearly four times greater odds of having depression.
Researchers also reviewed employment statistics.
Of participants with stroke, 71 per cent were employed two years prior to their stroke compared to 76 per cent of those without stroke. By the end of the study, 66 per cent of those with stroke were employed compared to 78 per cent of those without stroke.
After adjusting for age, researchers found that participants with stroke had 45 per cent lower odds of being employed and nearly five times greater odds of being retired at the end of the study compared to those without stroke.
Richardt said: “Of those with stroke, 92 per cent had good functional outcomes, meaning they had either completely recovered or could manage most daily activities by the end of the study.
“Still, more than one-third of those with stroke were out of work at the end of the study.
“Our findings highlight the need for adequate stroke prevention, monitoring and rehabilitation to improve the long-term health for those who have stroke during pregnancy.”
A limitation of the study was the small number of participants with stroke since stroke during pregnancy is rare.
Insight
UK reviews surrogacy firm over rejected insurance claims

The UK government is reviewing a surrogacy firm after complaints that medical insurance claims involving surrogates in Mexico were rejected.
The Department of Health and Social Care (DHSC) is considering whether UK-based provider My Surrogacy Journey should remain listed on gov.uk as one of four domestic surrogacy agencies available to intended parents.
The review follows allegations concerning its Mexican sister company, where surrogates are based.
Health minister Diana Johnson said: “The department is looking into the allegations about My Surrogacy Journey.
“As part of that assessment, the department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.”
Emails sent by My Surrogacy Journey chief executive Michael Johnson-Ellis and seen by the Guardian suggest multiple surrogate women in Mexico had their insurance claims rejected.
The emails also suggest 300 couples using the company were moved to a new insurance provider because of the increased risk of claims being rejected.
Commercial surrogacy is banned in the UK, where only altruistic arrangements are permitted.
My Surrogacy Journey operates a not-for-profit UK branch alongside for-profit sister companies in Mexico and the US. All three companies have the same owners and chief executives.
The reported insurance issues relate to surrogacy arrangements in Mexico.
One couple told the Guardian they paid tens of thousands of pounds to cover medical costs after their surrogate had a hysterectomy during childbirth and an insurance claim was refused.
The Guardian said it understood that at least five sets of parents said they had to cover medical costs after insurance claims were rejected.
In an email to the couple whose surrogate underwent a hysterectomy, Johnson-Ellis wrote: “We have already told you that the insurance companies have been declining some of the claims and we are actively working with the broker to get this issue resolved but you should also consider that they may not be paid out and there is nothing we are able to do to change this …
“We appreciate this is not an insignificant sum but this genuinely is out of our control.”
Johnson-Ellis also said the company had switched insurance providers, writing: “We’re also managing this for 300 other journeys, which is a complex position to be in.”
Lawyers acting for My Surrogacy Journey said the company did not comment on individual cases, but that existing insurance policies were in place and claims continued to be accepted and processed.
They said the company understood that a small number of claims had been rejected and was supporting people seeking to resolve those claims with an insurer.
Under the surrogacy arrangements, intended parents are understood to be contractually required to cover medical costs not paid by an insurer.
The couple said they had been recommended the company’s Mexico option. Its website advertises that intended parents using the route can have a baby in “under 18 months”.
They said they were told the UK route could take up to five years and that the US option was much more expensive.
Lawyers for My Surrogacy Journey said prospective parents are given information about typical timelines, costs, legal frameworks and practical considerations, and that the 18-month timeframe is indicative only.
The couple said their surrogate developed placenta accreta, a serious condition in which the placenta attaches to the wall of the uterus.
Emails from Johnson-Ellis acknowledged that the insurance provider investigated the birth after the surrogate experienced health complications.
The parents are considering legal action, while the Guardian said it understood at least four other couples were reviewing their options.
Phil Brickell, MP for Bolton West, raised concerns in parliament about a separate couple who had used My Surrogacy Journey.
He said: “Two of my constituents recently travelled to Mexico, where their children were born by surrogacy.
“Those births were facilitated by a company called My Surrogacy Journey, which is listed on gov.uk.
“While in Mexico, they had repeated traumatic experiences with the company relating to issues including insurance for their children, accusations of bullying towards staff and repeated efforts to silence any constructive criticism.
“I understand that other members of this house have received similar complaints.”
Brickell called for My Surrogacy Journey to be removed from gov.uk pending a review by the Human Fertilisation and Embryology Authority.
Lawyers acting for My Surrogacy Journey said the company was communicating with DHSC and was confident any issues could be resolved.
Cancer
Research uncovers potential new target for breast cancer therapy

Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.
The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.
Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.
Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.
They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.
The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.
When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.
The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.
Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.
They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.
A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.
However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.
Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.
“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.
“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.
“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”
Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.
They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.
The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.
Insight
Fertility rate in England and Wales hits record low, new figures reveal

The fertility rate in England and Wales fell to a record low of 1.39 children per woman in 2025, down from 1.41 a year earlier.
New figures show that parts of London and cities with major universities accounted for many of the areas with the lowest local fertility rates.
The City of London recorded the lowest rate in 2025 at 0.37 children per woman, followed by Cambridge at 0.87 and the London boroughs of Islington and Westminster at 0.90.
The Office for National Statistics (ONS) defines the fertility rate as the average number of live children women would expect to have over their childbearing lives.
Brighton & Hove recorded a rate of 0.95, followed by Southwark at 0.97 and Norwich at 0.98.
Exeter, Oxford and York, along with the London boroughs of Camden and Hammersmith & Fulham, each recorded 1.01 children per woman.
At the other end of the table, Pendle in Lancashire and Luton in Bedfordshire had the highest rate at 1.93.
They were followed by Oldham in Greater Manchester at 1.87, Bradford in West Yorkshire at 1.84 and Barking & Dagenham in London at 1.83.
The overall fertility rate for England and Wales declined from 1.41 in 2024 to 1.39 in 2025.
A rate of around 2.1 is needed for a population to remain stable over time when the impact of migration is excluded.
Twelve of the 25 local authorities with the lowest fertility rates in 2025 were in London.
In Wales, Swansea recorded the lowest fertility rate at 1.18, while Carmarthenshire, the Isle of Anglesey and Newport each had the highest rate at 1.48.
There were 585,396 live births in England and Wales in 2025, down from 594,677 in 2024 and the lowest number since 1977.
Live births fell across every region in England. The West Midlands recorded the largest percentage decline at 3.1 per cent, while the North East had the smallest at 0.3 per cent.
The average age of parents also increased slightly.
Mothers had a provisional standardised mean age of 31.1 in 2025, compared with 31.0 in 2024. Fathers had an average age of 34.0, up from 33.9.
In 1975, the average age was 26.4 for mothers and 29.5 for fathers.
The proportion of births where the mother was born outside the UK also increased, from 20.8 per cent in 2005 to 27.5 per cent in 2015 and 34.6 per cent in 2025.
India was the most common country of birth for non-UK-born mothers in 2025 for the fourth consecutive year.
It was followed by Pakistan, Nigeria and Romania.
In 2025, 56.4 per cent of births were to parents who were both born in the UK, down from 62.7 per cent in 2015.
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