Preeclampsia and pregnancy-associated stroke
In women with preeclampsia, certain conditions may increase the risk of pregnancy-associated stroke, according to results of a new study published in Stroke.
Researchers used billing data in the New York State Department of Health inpatient database from 2003 to 2012 to match women with preeclampsia and pregnancy-associated stroke 1:3 to preeclamptic controls, based on age and race/ethnicity. Risk factors for pregnancy-associated stroke included infection present on admission, vascular risk factors, prothrombotic state, coagulopathies, and pregnancy complications. Multivariable conditional logistic regression models were used to calculate odds ratios (ORs).
Among the women aged 12 to 55 years who were admitted to New York State hospitals for any reason during the study period (n = 3,373,114), preeclampsia was found in 88,857 and 197 of them had pregnancy-associated stroke. Following multivariable analysis, the researchers found that women who had both preeclampsia and stroke were more likely than the controls to have infections present on admission (OR, 3.0; 95% confidence interval [CI], 1.6–5.8); coagulopathies (OR, 3.1; 95% CI, 1.3–7.1); chronic hypertension (OR, 3.2; 95% CI, 1.8–5.5); severe preeclampsia or eclampsia. Results were confirmed with additional analysis matched and stratified by preeclampsia severity.
The researchers concluded that many factors, such as infection and coagulopathies, appear to increase the risk of pregnancy-associated stroke in women who have preeclampsia, which means that those who present with preeclampsia and one or more of the factors should be monitored more closely.