Chun-An Cheng1,2, Jiunn-Tay Lee1, Hung-Che Lin3, Hui-Chen Lin1, Chi-Hsiang Chung4,5, Fu-Huang Lin5, Chang-Huei Tsao4, Yung-Fu Wu4, Wu-Chien Chien4,5, Hung-Wen Chiu2. 1. From the Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 2. Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan. 3. Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 4. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 5. Department of Health Duties and Chronic Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Abstract
BACKGROUND: : The incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity. AIM: We aim to evaluate stroke risk in Asian women during and after pregnancy. DESIGN: : Using the Taiwan National Health Insurance database, we designed a retrospective study that included 18-45-year-old pregnant women between the years 2000 and 2010. We selected a 1:1 age-matched control group of non-pregnant women. The endpoint was any type of stroke during pregnancy or the postpartum period; otherwise, the patients were tracked until 31 December 2010. METHODS: : The risk factors for stroke were found using Cox proportional regression to calculate the hazard ratio (HR) with a 95% CI compared with the control group. RESULTS: : The incidence of stroke within 1 year postpartum was 71/100,000. The risk of postpartum stroke within 1 year was an HR of 1.208 (95% CI: 1.001-5.129). The occurrence of stroke was associated with hypertension, diabetes mellitus, coagulation disorders, migraine, obesity, cerebrovascular malformation and parity. Women with third and fourth parity carried increased risks of 13.3% and 2.5%, respectively, compared with first parity women. In long-term follow-ups, stroke risk was significantly lower, with an adjusted HR of 0.362 (95% CI: 0.269-0.489). CONCLUSION: The risk of stroke was elevated during the first year postpartum, but lower in subsequent years. Stroke risk increased in multiparous (≥3) women. Physicians should be on alert for pregnancy complications and ensure appropriate management to prevent postpartum stroke.
BACKGROUND: : The incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity. AIM: We aim to evaluate stroke risk in Asian women during and after pregnancy. DESIGN: : Using the Taiwan National Health Insurance database, we designed a retrospective study that included 18-45-year-old pregnant women between the years 2000 and 2010. We selected a 1:1 age-matched control group of non-pregnant women. The endpoint was any type of stroke during pregnancy or the postpartum period; otherwise, the patients were tracked until 31 December 2010. METHODS: : The risk factors for stroke were found using Cox proportional regression to calculate the hazard ratio (HR) with a 95% CI compared with the control group. RESULTS: : The incidence of stroke within 1 year postpartum was 71/100,000. The risk of postpartum stroke within 1 year was an HR of 1.208 (95% CI: 1.001-5.129). The occurrence of stroke was associated with hypertension, diabetes mellitus, coagulation disorders, migraine, obesity, cerebrovascular malformation and parity. Women with third and fourth parity carried increased risks of 13.3% and 2.5%, respectively, compared with first parity women. In long-term follow-ups, stroke risk was significantly lower, with an adjusted HR of 0.362 (95% CI: 0.269-0.489). CONCLUSION: The risk of stroke was elevated during the first year postpartum, but lower in subsequent years. Stroke risk increased in multiparous (≥3) women. Physicians should be on alert for pregnancy complications and ensure appropriate management to prevent postpartum stroke.
Authors: Natalia I Gokina; Rebecca I Fairchild; Kirtika Prakash; Nicole M DeLance; Elizabeth A Bonney Journal: Front Physiol Date: 2021-06-16 Impact factor: 4.566