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Infections, chronic hypertension increase risk for stroke in women with preeclampsia
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Chronic hypertension, infections, underlying prothrombotic conditions and coagulopathies increased risk for pregnancy-associated stroke in women with preeclampsia, according to findings published in Stroke.
“Preeclampsia is a very complex disorder that’s not completely understood,” Eliza Miller, MD, a vascular neurology fellow at NewYork-Presbyterian Hospital/Columbia University Medical Center, said in a press release. “Our study sought to discover if there are other risk factors or clues that may help identify the women with preeclampsia who are at the highest risk for pregnancy-related stroke. We were looking for risk factors that could be prevented or treated.”
Researchers analyzed data from 88,857 women aged 12 to 55 years (median age, 32 years) admitted to the hospital with preeclampsia, of which 0.2% (n = 197) had pregnancy-associated stroke. Of the cohort with stroke, mild preeclampsia was seen in 28.9% (n = 57), 42.1% (n = 83) had severe preeclampsia and 28.9% (n = 57) had eclampsia.
Significant risk factors for stroke included eclampsia or severe preeclampsia (OR = 7.2; 95% CI, 4.6-11.3), chronic hypertension (OR = 3.2; 95% CI, 1.8-5.5), infections present on admission (OR = 3; 95% CI, 1.6-5.8), coagulopathies (OR = 3.1; 95% CI, 1.3-7.1) and prothrombotic states (OR = 3.5; 95% CI, 1.3-9.2) after adjustment for other risk factors.
“Heart disease has been identified as a risk factor for [pregnancy-associated stroke] in women with preeclampsia,” Miller and colleagues wrote. “After adjusting for other risk factors, our results failed to show significant between-group differences in heart disease. Similarly, we found no significant differences in stroke risk comparing other traditional vascular risk factors, such as diabetes, obesity, chronic renal disease, smoking and other substance abuse.”
When women with eclampsia were excluded from the analysis, the results were similar.
“Preeclampsia is a very common disorder, and a lot of people are not aware of its association with stroke,” Miller said in the release. “Women with preeclampsia should take any neurological symptoms, such as severe headache, very seriously, especially during the postpartum period. This needs to be a major focus of future stroke research in women.” – by Darlene Dobkowski
Disclosure: The researchers report no relevant financial disclosures.
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