Pregnancy Increases Stroke Risk up to One Year Postpartum and Reduces Long-term Risk.

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Pregnancy Increases Stroke Risk up to One Year Postpartum and Reduces Long-term Risk.

QJM. 2017 Jan 09;:

Authors: Cheng CA, Lee JT, Lin HC, Lin HC, Chung CH, Lin FH, Tsao CH, Wu YF, Chien WC, Chiu HW

Abstract
BackgroundThe incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity.AimWe aim to evaluate stroke risk in Asian women during and after pregnancy.DesignUsing the Taiwan National Health Insurance database (NHIRD), 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 December 31, 2010.MethodsThe risk factors for stroke were found using Cox proportional regression to calculate the hazard ratio (HR) with a 95% confidence interval (95% C.I.) compared to the control group.ResultsThe incidence of stroke within one year postpartum was 71/100000. The risk of postpartum stroke within one year was an HR of 1.208 (95% C.I.: 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% C.I.: 0.269-0.489).ConclusionThe 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.

PMID: 28069909 [PubMed - as supplied by publisher]

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