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Cerebrovasc Dis. 2018;46(1-2):10-15. doi: 10.1159/000490803. Epub 2018 Jul 6.

The Impact of Pregnancy on Hemorrhagic Stroke in Young Women.

Author information

1
Department of Neurology, New York, New York, USA.
2
Departments of Pathology and Cell Biology and Pharmacology, New York, New York, USA.
3
Columbia Neuroscience Translational Initiative Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA.

Abstract

BACKGROUND:

Pregnancy is a sex-specific risk factor for causing hemorrhagic stroke (HS) in young adults. Unique physiological characteristics during pregnancy may alter the relative risk for HS in pregnant/postpartum (PP) women compared to HS in other young women. We compared patient characteristics and HS subtypes between young non-pregnant and PP women.

METHODS:

We reviewed the medical records of all women 18-45 years old admitted to our center with HS from October 15, 2008 through March 31, 2015, and compared patient characteristics and stroke mechanisms using logistic regression.

RESULTS:

Of the 130 young women with HS during the study period, 111 were non-PP women, and 19 PP women. PP women had lower proportions of vascular risk factors such as hypertension, prior stroke, and smoking, and a higher proportion of migraine (36.8 vs. 14.4%, p = 0.01). After adjusting for hypertension, smoking, migraine, prior stroke and prior myocardial infarction, PP women had lower odds of having an underlying vascular lesion (OR 0.14, 95% CI 0.04-0.44, p = 0.0009) and a higher proportion of the reversible cerebral vasoconstriction syndrome (RCVS) as cause of their HS.

CONCLUSIONS:

Women with pregnancy-associated HS had fewer cerebrovascular risk factors, lower odds of having -underlying vascular lesions, and higher proportion of -migraine and RCVS compared with similar-aged non--pregnant women. Pregnancy-associated HS appears to represent a unique pathophysiological process, requiring targeted study.

KEYWORDS:

Hemorrhagic stroke; Stroke etiology; Stroke in pregnancy

PMID:
29982254
PMCID:
PMC6158089
[Available on 2019-07-06]
DOI:
10.1159/000490803

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