Pregnancy increases stroke risk up to 1 year postpartum and reduces long-term risk

Chun An Cheng, Jiunn Tay Lee, Hung Che Lin, Hui Chen Lin, Chi Hsiang Chung, Fu Huang Lin, Chang Huei Tsao, Yung Fu Wu, Wu Chien Chien, Hung Wen Chiu

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7 Citations (Scopus)

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-yearold 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 postpartumperiod; 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 postpartumwas 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.

Original languageEnglish
Pages (from-to)355-360
Number of pages6
JournalQJM
Volume110
Issue number6
DOIs
Publication statusPublished - 2017

ASJC Scopus subject areas

  • Medicine(all)

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    Cheng, C. A., Lee, J. T., Lin, H. C., Lin, H. C., Chung, C. H., Lin, F. H., Tsao, C. H., Wu, Y. F., Chien, W. C., & Chiu, H. W. (2017). Pregnancy increases stroke risk up to 1 year postpartum and reduces long-term risk. QJM, 110(6), 355-360. https://doi.org/10.1093/qjmed/hcw222