In pregnancy-related stroke, in-hospital mortality risk elevated among Black women
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Among younger women with pregnancy-associated stroke, in-hospital mortality was higher in Black women compared with white women, according to research presented at the American Stroke Association’s virtual International Stroke Conference.
“We found that serious disparities exist despite adjusting for socioeconomic variables. This means that we cannot simply attribute the differences to socioeconomic factors such as income or access to health care that puts a woman more at risk. Those factors can contribute, yet they do not explain the whole story,” Mohamed M. Gad, MD, a resident physician in the department of internal medicine at Cleveland Clinic, said in a press release.
The researchers analyzed a cohort of 38,797,752 pregnant and postpartum women from the Nationwide Inpatient Sample in which 21.9% were Black and 0.03% had pregnancy-associated stroke.
The researchers found that 41% of the women who had a stroke during pregnancy were Black.
According to the researchers, among those with pregnancy-associated stroke, Black women had increased risk for in-hospital death compared with white women (7.8% vs. 5%; P < .001).
Gad and colleagues found the disparity in in-hospital mortality varied by age (aged 18-24 years: adjusted OR = 2.1; 95% CI, 1.88-2.35; P < .001; aged 25-29 years: aOR = 2.75; 95% CI, 2.46-3.07; P < .001; aged 30-34 years: aOR = 3.94; 95% CI, 3.5-4.43; P < .001; aged 35-39 years: aOR = 3.73; 95% CI, 3.25-4.29; P < .001; aged at least 40 years: aOR = 1.27; 95% CI, 1.08-1.51; P = .005).
In an analysis of pregnancy-associated stroke outcomes by income levels, the disparity in in-hospital mortality was less pronounced in women with low incomes (aOR = 1.91; 95% CI, 1.74-2.1) than in women with high incomes (aOR = 2.38; 95% CI, 2.02-2.8).
Targeted interventions would help to minimize the racial disparities, the researchers wrote in an abstract.
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Gad MM, et al. Presentation P869. International Stroke Conference; March 17-19, 2021 (virtual meeting).
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