Abstract WP186: Pregnancy Associated Hemorrhagic Strokes Differ in Mechanisms and Risk Factors Compared with Hemorrhagic Strokes in Non-pregnant Young Women and Men
| Autor: | Joshua Z. Willey, Randolph S. Marshall, Amelia K. Boehme, Eliza C. Miller, Kathryn M Sundheim |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Advanced and Specialized Nursing
Intracerebral hemorrhage medicine.medical_specialty Pregnancy Subarachnoid hemorrhage Obstetrics business.industry Hemorrhagic strokes medicine.disease Non pregnant Pathophysiology medicine cardiovascular diseases Neurology (clinical) Cardiology and Cardiovascular Medicine business Stroke reproductive and urinary physiology |
| Zdroj: | Stroke. 48 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/str.48.suppl_1.wp186 |
| Popis: | Background: Pregnancy-associated hemorrhagic stroke (HS), while rare, is a significant cause of maternal mortality. Prior studies have suggested that the pathophysiology of HS may differ in pregnant/postpartum women when compared with HS in other young adults. Methods: We conducted a single-center retrospective analysis of a prospectively collected stroke registry, for patients aged 18-45, admitted with HS of any type from 01/2008-03/2015. We reviewed charts for study variables, including patient characteristics, risk factors, stroke mechanisms, and outcomes. Good outcome was defined as modified Rankin score of 0-2 at time of discharge. We compared study variables between three groups: pregnant/postpartum women, non-pregnant/postpartum women, and men. Results: Of 219 young adults with HS during the study period, 93 (42%) were men and 126 (58%) were women, of whom 19 (15.1%) were pregnant/postpartum. Among men, 58 (62.4%) had ICH and 41 (33.3%) had SAH, 31 (75.6%) of which were aneurysmal. Among non-pregnant women, 49 (45.8%) had ICH and 61 (57%) had SAH, 53 (87%) of which were aneurysmal. Among pregnant/postpartum women, 10 had ICH (52.6%) and 11 (57.9%) had SAH, 1 of which was aneurysmal. Compared with men and with non-pregnant women, pregnant/postpartum women had fewer vascular risk factors, were more likely to have history of migraine, and were more likely to have the reversible cerebral vasoconstriction syndrome as stroke mechanism (11/19, 57.9% versus 0/93 men and 2/107 non-pregnant women, p=0.0001). While there were no deaths in the pregnant/postpartum group, there were no significant differences between groups in good outcome (Table). Conclusions: In our analysis, pregnancy-associated hemorrhages were uniquely non-aneurysmal and associated with fewer cerebrovascular risk factors than age-matched men and non-pregnant women, suggesting there is a pregnancy-specific pathophysiology for HS that requires special consideration. |
| Databáze: | OpenAIRE |
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