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Abstract 158: Stroke During Pregnancy: Risk Factors, Clinical Outcomes, And Recurrence
Abstract   Peer reviewed

Abstract 158: Stroke During Pregnancy: Risk Factors, Clinical Outcomes, And Recurrence

Aayushi Garg, Hannah Roeder and Enrique C. C Leira
Stroke (1970), Vol.53(2), p.A158
02/01/2022
DOI: 10.1161/str.53.suppl_1.158

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Abstract

Byline: Aayushi Garg, Univ of Iowa, Iowa City, IA; Hannah Roeder; Enrique C. C Leira Background: There is limited data regarding the clinical course of acute stroke during pregnancy. Methods: Pregnancy-related hospitalizations with age>18 years were identified from the Nationwide Readmissions Database 2016-2018. Logistic regression and survival analyses were used to compare the risk factors, outcomes, and readmissions in patients with and without acute strokes. Results: There were 11829044 pregnancy-related hospitalizations, of which 3498 had acute stroke and a 5% random sample of the remaining non-stroke hospitalizations (N=628106) were included as controls (meanØSD age: 29.0Ø5.7 years). Intracranial hemorrhage (ICH) was present in 1952 (55.8%) cases, acute ischemic stroke (AIS) in 1646 (47.1%) cases, and cerebral venous sinus thrombosis in 105 (3.0%) cases. We identified several independent factors associated with acute stroke during index hospitalization (figure 1). Among patients with AIS, 60 (4.0%) received intravenous thrombolysis and 95 (6.3%) underwent mechanical thrombectomy. Among patients with ICH, 420 (23.5%) had catheter angiogram, 177 (9.9%) underwent ventriculostomy, and 14 (0.8%) underwent decompressive craniotomy. Patients with stroke had longer length of stay (mean: 11.7 vs. 2.8 days), higher in-hospital mortality (5.3% vs. 0.0001%) and were less likely to discharge home (70.3% vs. 98.4%). Non-elective readmission within 90 days of discharge occurred in 17% of patients with stroke versus in 3% without stroke [hazards ratio (HR): 5.6, 95% confidence interval (CI): 4.8-6.6]. Readmissions due to cerebrovascular events occurred in 1.8% of patients with stroke versus in 0.00004% of patients without stroke (HR: 438.6, 95% CI: 211.0-911.9) within 1 year of discharge, with meanØSD time to readmission 43.1Ø60.8 days. Conclusion: Stroke during pregnancy is associated with very high morbidity and mortality. Recurrence of stroke occurs in a small proportion of patients and the risk is highest during the first month.
 Patient outcomes Pregnant women Risk factors Stroke (Disease)

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