Objective: To estimate the incidence of antenatal stroke in the United Kingdom and to describe risk factors associated with stroke during pregnancy, management, and outcomes.
Methods: A population-based (nationwide) cohort and nested case-control study was conducted using the UK Obstetric Surveillance System between October 2007 and March 2010. We investigated the potential factors associated with antenatal stroke using a logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
Results: Thirty cases of antenatal stroke were reported giving an estimated incidence of 1.5 cases per 100,000 women delivering (95% CI 1.0-2.1). The incidences of nonhemorrhagic and hemorrhagic stroke were 0.9 (95% CI 0.5-1.3) and 0.6 (95% CI 0.3-1.0) per 100,000 women delivering. Factors associated with increased risk of antenatal stroke were history of migraine (adjusted OR 8.5, 95% CI 1.5-62.1), gestational diabetes (adjusted OR 26.8, 95% CI 3.2-∞), and preeclampsia or eclampsia (adjusted OR 7.7, 95% CI 1.3-55.7). There was wide variation in the use of pharmacologic, surgical, and organized stroke unit care. There were six stroke-related maternal deaths giving a case-fatality rate of 20% of all strokes, 50% of hemorrhagic strokes, and a mortality rate of 0.3 (95% CI 0.1-0.6) per 100,000 women delivering.
Conclusion: The risk of a stroke during pregnancy is low; however, the poor outcomes in terms of morbidity and mortality and variations in care highlight the importance of such women receiving specialist stroke care. Clinicians should be aware of an association with a history of migraine, gestational diabetes, and preeclampsia or eclampsia.
Level Of Evidence: II.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/AOG.0b013e31825f287c | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Antenatal pelvic floor muscle exercise intervention led by midwives in England to reduce postnatal urinary incontinence: APPEAL feasibility and pilot randomised controlled cluster trial.
BMJ Open
January 2025
University of Exeter Medical school, University of Exeter, Exeter, UK.
Objectives: To assess the feasibility of an intervention of midwifery support for antenatal pelvic floor muscle exercises (PFME) to prevent postnatal urinary incontinence (UI).
Design: Feasibility and pilot cluster randomised controlled trial. Clusters were community midwifery teams.
Outcomes of Postpartum Preeclampsia: A Retrospective Cohort Study of 1.3 Million Pregnancies.
BJOG
December 2024
University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.
Article Synopsis
- This study examined how postpartum preeclampsia affects maternal and neonatal outcomes using data from over 1.3 million pregnancies in Quebec from 2006 to 2022.
- Postpartum preeclampsia was less common than antepartum preeclampsia but was linked to higher risks of preterm birth, placental abruption, and severe maternal complications.
- The research suggests that women who experience postpartum preeclampsia should have their blood pressure monitored for up to six weeks after delivery to identify any adverse effects.
Identification and Functional Investigation of as a Novel Gene Underpinning Familial Atrial Fibrillation.
Diagnostics (Basel)
October 2024
Department of Cardiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.
Atrial fibrillation (AF) signifies the most prevalent supraventricular arrhythmia in humans and may lead to cerebral stroke, cardiac failure, and even premature demise. Aggregating strong evidence points to genetic components as a cornerstone in the etiopathogenesis of familial AF. However, the genetic determinants for AF in most patients remain elusive.
View Article and Find Full Text PDFOutcomes of peripartum cardiomyopathy in North Africa: insights from a single-center observational study in Tunisia.
BMC Pregnancy Childbirth
November 2024
Department of Gynecology and Obstetrics, Faculty of Medicine, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
Article Synopsis
- - Peripartum cardiomyopathy (PPCM) is a rare and serious heart condition often occurring during or after pregnancy; this study assessed its outcomes in North Africa over a 12-year period from 2010 to 2022.
- - Out of 27 PPCM patients studied, most presented symptoms like severe dyspnea and had a low average heart function measurement (LVEF of 30%); complications included pulmonary edema (85%) and the need for ECMO support in two patients.
- - The follow-up revealed that 67% of patients showed recovery in heart function, but the overall mortality rate was 15%, with significant mortality associated with factors like past pregnancies and poor prenatal care.
Theoretical Domains Framework: A Bibliometric and Visualization Analysis from 2005-2023.
J Multidiscip Healthc
August 2024
Nursing Department, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China.
Background: The Theoretical Domains Framework (TDF) is among the most extensively utilised foundational frameworks in implementation science. It was developed from 33 psychological theories, with the latest version identifying 14 domains encompassing 84 theoretical constructs. These domains and constructs capture the complexity of factors that affect behaviours, making the framework a valuable tool for designing and implementing interventions within health and social care settings.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!