Intracerebral hemorrhage rare in pregnancy, linked to lower in-hospital mortality

Key takeaways:

• Researchers analyzed more than 2 million individuals with intracerebral hemorrhage over a 20-year span.
• A greater percentage of pregnant ICH patients were African American.

Compared with the general population, intracerebral hemorrhage in pregnancy is a rare occurrence with lower in-hospital mortality, according to a poster presented at the International Stroke Conference.

“Pregnant patients are at risk of neurological complications including intracerebral hemorrhage,” Amol Mehta, MD, vascular neurology fellow at Icahn School of Medicine at Mount Sinai, and colleagues wrote.

Mehta and colleagues sought to characterize this risk and its in-hospital consequences by analyzing a large population-based sample with intracerebral hemorrhage (ICH) over a 20-year study period.

Their data was acquired from the Nationwide Inpatient Sample between 2000 and 2019, which yielded more than 2 million individuals with ICH, of which 5,107 were pregnant. Researchers compared characteristics between the pregnant and non-pregnant populations utilizing t-tests and chi-squared tests, while further analysis was performed via a 1:1 propensity score matched cohort.

Variables with standardized mean differences > 0.1 were employed with multivariable regression to generate adjusted odds ratios/beta coefficients to determine the impact of pregnancy on outcomes.

Mehta and colleagues observed an increasing trend of ICH among pregnant individuals who were younger (30.63 years old vs. 63.38) and had fewer comorbidities such as cancer and chronic kidney disease, atrial fibrillation, hypertension and hyperlipidemia.

Further analysis revealed a greater percentage of pregnant patients with ICH were African American (25% vs. 16.2%). The researchers wrote that pregnant patientsexperienced lower in-hospital mortality (12.4% vs. 24.7%) and were more frequently discharged home or to short-term hospital stays (53.8% vs. 23.2%). After propensity matching, pregnant individuals had lower odds of in-hospital mortality (aOR = 0.68, P = 0.008), but other outcomes including discharge outcomes and hospital charges were similar for both groups.

“There may be a racial disparity in pregnancy related [intracerebral hemorrhage] as well, with African Americans experiencing this complication at a higher rate than other races,” Mehta and colleagues wrote.

“[Intracerebral hemorrhage] is a rare complication in pregnancy, occurring in 0.26% of cases, and presenting roughly a 14% risk of in-hospital mortality,” they wrote. “However, patients appear to have lower rates of mortality than the overall ICH population,”