Impact of preeclampsia/eclampsia on hemorrhagic and ischemic stroke risk: A 17 years follow-up nationwide cohort study

Abstract

Background and purposes The long-term risk of stroke in women with preeclampsia/eclampsia is a concerning issue. In this study we further investigated different stroke subtypes and differentiated follow-up time intervals. Methods Between 2000 and 2017, 1,384,427 pregnant women were registered in the National Health Insurance Research Database in Taiwan. After excluding women with previous stroke history and exact matching with all confounders, 6,053 women with preeclampsia/eclampsia and 24,212 controls were included in the analysis sample. Results Over the 17-year follow-up, the adjusted hazard ratio (aHR) for stroke in women with preeclampsia/eclampsia was 2.05 (95% confidence interval, CI = 1.67–2.52, p<0.001). The 17 years overall aHR of both ischemic and hemorrhagic stroke were 1.98 and 3.45, respectively (p<0.001). The stroke subtypes, hemorrhagic and ischemic, had different time trend risks, and hemorrhagic stroke risks kept higher than that of ischemic stroke. The aHR of ischemic stroke reached a peak during 1–3 years after childbirth (aHR = 3.09). The aHR of hemorrhagic stroke reached a peak during 3–5 years (aHR = 7.49). Conclusions Stroke risk persisted even after decades, for both ischemic and hemorrhagic subtypes. Women with preeclampsia/eclampsia history should be aware of the long-term risk of stroke.

Stroke in a Retrospective Cohort of Patients with Eclampsia

“…Patients with eclampsia and stroke currently represent a diagnostic and therapeutic challenge with a high degree of difficulty that has not been resolved [28]. Furthermore, contemporary research suggests an association between preeclampsia and stroke during pregnancy and postpartum, but also in later life [13,14,29].…”

“…once it has greater aggressiveness, percentage of mortality and long-term sequelae. The correlation of clinical data with imaging studies is the most valuable tool to establish the neurological diagnosis and the bases for conservative management, indications for surgery and the prognosis of the patients [10][11][12][13][14]. The aim of the study was To identify the incidence, vascular origin, type and outcome of stroke in a retrospective cohort of patients with eclampsia.…”

Penyiapan Pengelolaan Pasca Rawat pada Pasien Stroke Hemoragik dengan Riwayat Peb: Case Report

“…Salah satu kelompok individu yang berisiko tinggi mengalami stroke adalah ibu hamil dengan Preeklampsia berat (PEB). Secara patofisiologi PEB berpotensi menyebabkan komplikasi yang serius pada masalah ginjal, pembuluh darah otak, pembekuan darah, atau bahkan kematian obstetric secara langsung (Chuang et al, 2022). Kejadian stroke pada PEB relatif jarang terjadi selama masa kehamilan berkisar 10 -34/100.000 kelahiran.…”

Assessing the Impact of the Zero Mother Mortality Preeclampsia Program on Maternal Mortality Rates at a Single Center in Bandung, West Java (2015-2022): A Retrospective Study

“…Preeclampsia-related deaths are secondary, mainly as a result of severe instances like the development of eclampsia, or the advent of aggravating comorbidities including heart failure and pulmonary edema, or stroke [ 9 , 10 ]. Efforts are being made to prevent maternal death due to hypertension in pregnancy by early detection, and prevention programs [ 11 , 12 ].…”