Hypertensive Disorders in Pregnancy and Preterm Delivery and Subsequent Stroke in Asian Women

Abstract

Background and Purpose-Few studies exist concerning the risk of stroke associated with hypertensive disorders in pregnancy (HDP) in Asian women. This study investigates whether preterm delivery further complicates this risk in women with HDP in Taiwan. Methods-Based on universal insurance claims data, 1092 pregnant women with newly diagnosed HDP from 2000 to 2004 and aged 15 to 40 years were identified as the HDP cohort. Then, 4715 randomly selected persons without HDP frequency matched with the index year were designated as the non-HDP controls. Both cohorts were followed-up until the end of 2008 to measure the incidence of stroke. Results-The HDP cohort had a higher incidence of stroke than the non-HDP cohort (30.1 vs 12.8 per 10 000person-years), with an overall adjusted hazard ratio of 2.04 (95% CI, 1.18-3.51) for stroke. Preterm delivery increased the risk of stroke to 3.22-fold (95% CI, 1.48 -6.99; P for trendϭ0.002). The age-specific V-shape risk association showed that the highest risk of stroke was noted among subjects 15 to 18 years old in the HDP group (hazard ratio, 13.4; 95% CI, 1.54 -116.7) and followed by women aged 35 years and older (hazard ratio, 5.56; 95% CI, 1.47-21.0). Conclusions-Pregnant

Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study

“…A retrospective, population-based cohort study was conducted using medical claims from Taiwan's National Health Institute Research Database (NHIRD), which has been described previously 15. Our database randomly selected 1 million insured subjects from the NHIRD database comprising healthcare data from the medical records of all beneficiaries, more than 99% of the 23.37 million people in Taiwan.…”

Stroke: Morbidity, Risk Factors, and Care in Taiwan

“…They found that adhering to the DASH diet was beneficial for long term blood pressure control and reduction of stroke risk (HR [hazard ratio], 0.63; 95% CI, 0.41-0.98; P =0.037) in Taiwanese population. Another study using pregnant women as study cohort reported that women with hypertensive disorders in pregnancy had an increased risk of subsequent stroke (adjusted HR, 2.04; 95% CI, 1.18-3.51) 16. Among predictors for ischemic stroke in patients with atrial fibrillation, hypertension was the most powerful predictor except for prior TIA/stroke, and the magnitude of association (OR, 2.656; 95% CI, 2.140-3.296) was greater than observed in white populations 17…”

Miscarriage and future maternal cardiovascular disease: a systematic review and meta-analysis

“…The resulting concept that the unique cardiovascular stress that occurs during pregnancy can improve risk prediction was recently acknowledged in the 2011 American Heart Association guidelines, which incorporated obstetric complications in the classification of cardiovascular disease (CVD) risk in women 2. The cardiovascular impact of a range of obstetric complications was discussed, including pre-eclampsia,3–5 preterm birth4 6 7 and gestational diabetes 8 9. However, the long-term cardiovascular implications of miscarriages were not considered.…”