Pregnancy‐associated stroke and the recurrence of stroke and other complications in subsequent pregnancies: Population‐based retrospective cohort study

Karjalainen, Liisa; Tikkanen, Minna; Äyräs, Outi; Aarnio, Karoliina; Rantanen, Kirsi; Korhonen, Aino; Richardt, Anna; Laivuori, Hannele; Gissler, Mika; Ijäs, Petra

doi:10.1111/1471-0528.17503

Cited by 3 publications

(2 citation statements)

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“…A detailed description of the characteristics of recurrent maternal strokes has been published separately. 19 The distribution of subsequent strokes by stroke subtypes is presented in Table 3. Among controls, there were 2 ISs and 2 CVTs, of which one during early pregnancy ending in induced abortion.…”

Section: Resultsmentioning

confidence: 99%

Long-Term Mortality, Recovery, and Vocational Status After a Maternal Stroke

Verho,

Aarnio,

Tikkanen

et al. 2024

Neurology

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Background and ObjectivesMaternal stroke is a rare event with an increasing incidence. Data on the long-term prognosis after a maternal stroke are limited. We aimed to examine long-term mortality, recovery, vocational status and morbidity after a maternal stroke in a population-based setting including a comparison with matched, stroke-free controls. MethodsIn this register-based study with hospital chart validation, we included all women with a maternal stroke in Finland in 1987-2016 who survived the first year after the event. The recovery of the cases was assessed from the hospital charts by modified Rankin scale (mRS). Three controls matched by delivery year, age, and parity were selected for each case. All deaths until 2022 were identified from the Register for Causes of Death. Data on vocational status were obtained from Statistics Finland and morbidity from the Hospital Discharge Register and patient charts until year 2016. ResultsThe study included 235 women with a maternal stroke and 694 matched controls. The median follow-up time was 17.5 years (interquartile range [IQR] 9.6-25.4) for mortality and 11.8 years (IQR 3.8-19.8) for vocational status and subsequent morbidity. Mortality among cases was 5.5% and among controls, 2.4% (age-adjusted odds ratio [OR] 2.3, 95% [CI] 1.1-4.9). At the end of the follow-up, 90.3% of the cases were independent in daily activities (mRS ≤2). In 2016, fewer women with a maternal stroke were working compared with controls (65.9% vs 79.1%, OR 0.5, 95% CI 0.4-0.7) and were more often receiving a pension (18.2% vs 4.9%, OR 4.4, 95% CI 2.7-7.3). Cerebrovascular events (age-adjusted OR 8.6 95% CI 4.4-17.1), cardiac diseases (age-adjusted OR 3.3, 95% CI 1.4-7.7), and major cardiovascular events were more common among cases during the follow-up (age-adjusted OR 7.6 95% CI 3.1-18.7). DiscussionDespite having higher overall mortality and higher cardiovascular morbidity, the majority of the maternal stroke survivors recovered well. As expected, the vocational status of cases was inferior to that of controls, but most women were working at the end of the follow-up. Our study provides important information on the prognosis and sequalae after a maternal stroke to help in patient counseling and to improve secondary prevention.

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Section: Resultsmentioning

confidence: 99%

Long-Term Mortality, Recovery, and Vocational Status After a Maternal Stroke

Verho,

Aarnio,

Tikkanen

et al. 2024

Neurology

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“…The incidence of stroke increased ve times during the early postpartum period compared to the rst trimester [23]. According to a Finnish study on Risk Factor Analysis 1987-2016 for stroke through pregnancy and the postpartum period and hypertension problems associated with pregnancy (OR 4.0, 95%) were the most common [24]. The majority of research participants did not disclose any prior history of stroke or risk factor, despite the fact that our study revealed that abortion and eclampsia histories are the most frequent risk factors for stroke during pregnancy and after delivery.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics and Risk factors of Stroke in Pregnancy and Postpartum Women in Somalia: A Retrospective Study

Sidow,

NAKUŞ,

Hassan

et al. 2024

Preprint

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Objective Stroke in women with pregnancies and postpartum periods has a higher level of vulnerability than in other people. The aim of this study is to provide information on the burden of stroke in pregnant women and after delivery, as well as discover the most risk factors for them causing the stroke and examine the types of stroke in Mogadishu, Somalia. Methods This is a retrospective study. The data was obtained from the health information system documented in the 3-year period between January 2020 and December 2022. All the women with pregnancy and seven weeks after delivery presenting with stroke clinical features in the emergency are included in this study. Patients who were admitted as neurology inpatients or ICUs were identified from the data by confirming the diagnosis with a first CT brain and an MRI brain with a venogram. The risk factor was taken from the doctors and progressive notes in the system. data was analyzed using the commonly used statistical package, SPSS version 26.0. Results This study included 102 pregnant and postpartum women who had acute strokes in an emergency department. 90 (88.2%) had a postpartum period, and 12 (11.8%) had a pregnancy. according to the age of the participants: 46 (45.1%) between 15 and 24 years, 32 (31.4%) between 25 and 34, and 24 (23.5%) between 15 and 24 years old. 70 (68.7%) had cerebral sinus vein thrombosis (CSVT), while 21 (20.5%) had ischemic stroke (SS), and 11 (10.8%) had hemorrhagic stroke (HS). There were no differences in the location of the infarction or hemorrhage site, and the documented clinical presentation of the stroke, but the CSVT presentation was different from the other strokes; most of them, 61.1 (88%) had a seizure with focal neurological deficit. 39 (38.2%) had superior sagittal sinus thrombosis, and 17 (16.7%) had transverse sinus thrombosis. For the risk factors of the stroke, 58 (56.9%) did not have any previous risk factors related to the stroke, 10 (9.8%) had a history of abortion, 10 (9.8%) had a history of preeclampsia and eclampsia, and 5 (4.9%) had a history of contraceptive use. Conclusion This study showed that the most common type of stroke in pregnant and postpartum women is cerebral sinus venous thrombosis, and the greatest risk factor is the same as pregnancy and postpartum with abortion, eclampsia, and preeclampsia. So, early recognition of these strokes in women during pregnancy and postpartum helps health professionals make early diagnoses with appropriate treatment.

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Pregnancy-Related Factors and Prediction of Peripartum Stroke

Kypshakbayeva,

Kurmanova,

Kurmanova

et al. 2024

Salud, Ciencia y Tecnología

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Objetive: to demonstrate the prediction tools, risk factors, and predisposing factors of peripartum stroke and its impact on the fetus and the mother. Method: in our review, we involved English studies from common databases such as Google Scholar, Pubmed/MEDLINE, Scopus, Web of Science, and the Cochrane Library with the keywords “prepartum,” “postpartum,” and “peripartum,” combined with keywords involving “maternal stroke,’’ and ‘’detection.” The end date for this review is September 2023. Scientific novelty: there are several studies that tried to determine the incidence, risk factors, management, and complications of maternal stroke; however, there are studies that attempted to identify an accurate prediction tool for peripartum stroke. In our article, we tried to identify an accurate prediction tool for peripartum stroke. Conclusion: our understanding of maternal stroke still has several limitations. Although risk indicators have been established, there are currently no techniques available to determine which females are more likely to experience postpartum strokes and need closer observation. The risk of a subsequent maternal stroke has not been clearly assessed, which limits the advice that clinicians can give patients

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Pregnancy‐associated stroke and the recurrence of stroke and other complications in subsequent pregnancies: Population‐based retrospective cohort study

Cited by 3 publications

References 30 publications

Long-Term Mortality, Recovery, and Vocational Status After a Maternal Stroke

Long-Term Mortality, Recovery, and Vocational Status After a Maternal Stroke

Epidemiological Characteristics and Risk factors of Stroke in Pregnancy and Postpartum Women in Somalia: A Retrospective Study

Pregnancy-Related Factors and Prediction of Peripartum Stroke

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