Abstract 29: Risk Of Early Onset Cerebrovascular Disease After Adverse Pregnancy Outcomes: A Population Based Cohort Study
| Autor: | Eliza C Miller, Anni Kauko, Sarah Tom, Hannele Laivuori, Teemu Niiranen, Natalie A Bello |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Stroke. 54 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background: Adverse pregnancy outcomes (APO) contribute to a higher risk of maternal cerebrovascular disease, but longitudinal data that include APO and stroke timing are lacking. We hypothesized that APO are associated with younger age at first stroke, with a larger effect in those with recurrent APO (rAPO), defined as >1 pregnancy with APO. Methods: We analyzed longitudinal Finnish nationwide health registry data from the FinnGen Study. We included people who gave birth after 1969 when birth and hospital discharge registries were established. We defined APO as a pregnancy affected by gestational hypertension, preeclampsia, eclampsia, preterm birth, small for gestational age infant, or placental abruption. We defined stroke as 1 st hospital admission for ischemic stroke, non-traumatic intracerebral hemorrhage or subarachnoid hemorrhage, or TIA, excluding stroke during pregnancy or within 1 year postpartum. Stroke and APO diagnoses were validated in the cohort. We created Kaplan Meier survival curves, Cox models, and logistic models to assess the relationship between APO and future stroke, adjusting for demographic and cardiovascular risk factors. Results: We included 130,764 individuals with a total of 285,545 births in the analysis sample, of whom 14.9% had 1 pregnancy with APO and 2.8% had rAPO. Those with any APO had higher proportion of obesity, hypertension, hyperlipidemia, heart disease and migraine. Median age at 1 st stroke was 58.5 years in those with no APO, 54.6 years in those with 1 APO, and 51.3 years in those with rAPO. In adjusted models, age at stroke was younger in those with APO (1 APO: adjusted HR 1.2, 95%CI 1.1-1.3; rAPO: adjusted HR 1.4, 95%CI 1.2-1.6) compared to those with no APO. Those with rAPO had twice the stroke risk before age 45 (adjusted OR 2.1, 95%CI 1.5-2.8), compared to those with no APO. Conclusion: People who experience APO have higher risk of early onset cerebrovascular disease, with earliest onset and greatest risk in those with rAPO. |
| Databáze: | OpenAIRE |
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