Increased Risk of Pregnancy Complications After Stroke

Alebeek, Mayte E van; Vrijer, Myrthe De; Arntz, Renate M.; Maaijwee, Noortje A.M.; Synhaeve, Nathalie E.; Schoonderwaldt, Hennie C.; Vlugt, Maureen J. van der; Dijk, Ewoud J. van; Heus, Roel de; Rutten-Jacobs, Loes C.A.; Leeuw, Frank Erik de

doi:10.1161/strokeaha.117.019904

Cited by 24 publications

(28 citation statements)

References 27 publications

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“…Alebeek et al [28] assessed the occurrence of pregnancy complications in women with a history of stroke (IS or TIA) using the Dutch general population as a control group. The data for the women with a stroke history were self-reported and collected by telephone interview and the data to represent the general population was retrieved from the Dutch Perinatal Registry or Dutch HELLP foundation.…”

Section: Resultsmentioning

confidence: 99%

“…the location or extend of CVT or did CVT result in ischemic or haemorrhagic stroke). In addition, four articles reporting subsequent health of women after PAS [19, 22, 28, 30] stated there were no recurrent PAS.…”

Section: Resultsmentioning

confidence: 99%

“…The initial type of stroke was not specified in 90/123 women (73%) whose subsequent health was assessed and reported. During the follow-up there were altogether three vascular events, all ISs or TIAs from the study of Alebeek et al [28]. The studies reporting long-term mortality included 101 women and 10 (10%) of these women died during the follow-up time up to 16 years, four from cardiovascular causes and six from other causes.…”

Section: Resultsmentioning

confidence: 99%

“…This may reflect more careful family planning after PAS. One study reported less favourable obstetric prognosis, more severe pregnancy complications and more miscarriages and foetal deaths in women with a history of stroke than in the general population [28]. However, there are several methodological problems in the study.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the findings may result from confounding risk factors. Also the frequencies of adverse pregnancy outcomes reported in the Dutch Perinatal Registry for the general populations are low and possibly under-reported [28], which may overestimate the differences between women with a stroke history and general population.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy-associated stroke –a systematic review of subsequent pregnancies and maternal health

Karjalainen

Tikkanen

Rantanen

et al. 2019

BMC Pregnancy Childbirth

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Background Pregnancy-associated stroke is a rare but life-threatening event, with an estimated incidence of 30/100000 deliveries. Data on the risk of stroke recurrence and the risk of other adverse pregnancy outcomes are essential for adequate counselling and surveillance in subsequent pregnancies. The aim of this systematic review is to describe the implications of a pregnancy-associated stroke for the future health of these women. Methods We searched Ovid Medline, PubMed, Cochrane Library and CINAHL for articles published in 1980–2018. Articles including women with pregnancy-associated stroke and information on at least one of the following outcomes were included: 1) recurrence of stroke during subsequent pregnancy, 2) number and course of subsequent pregnancies and their outcomes and 3) subsequent cardiovascular health. Results Twelve articles were included in the review, with six providing information on subsequent pregnancies, four on subsequent maternal health and two on both. The included articles varied greatly in terms of study design, length of follow up and reported outcomes. We found 252 women with pregnancy-associated stroke for whom the outcomes of interest were reported: 135 women with information on subsequent pregnancies and 123 women with information on future health. In total, 55 pregnancies after stroke were found. In the majority of studies, the incidence of pregnancy complications was comparable to that of the general population. The risk of stroke recurrence during pregnancy was 2%. Data on subsequent health of these women were limited, and the quality of the data varied between the studies. Conclusions Data on subsequent pregnancies and health of women with a history of pregnancy-associated stroke are limited. Further research on this topic is essential for adequate counselling and secondary prevention. Electronic supplementary material The online version of this article (10.1186/s12884-019-2339-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%