(Stroke. 2000;31:1274.)
© 2000 American Heart Association, Inc.
Original Contributions |
Risk Factors for Peripartum and Postpartum Stroke and Intracranial Venous Thrombosis
From the Department of Veterans Affairs Medical Center (D.J.L.), Great Lakes Health Care System, Tomah, Wisc; Department of Neurology (D.J.L.), University of Wisconsin (Madison); and Department of Statistics (R.J.K.), University of Kentucky (Lexington).
Correspondence to Douglas J. Lanska, MD, Chief of Staff (11), VAMC, 500 E Veterans St, Tomah, WI 54660. E-mail Douglas.Lanska{at}med.va.gov
Background and Purpose—The study goal was to identify potential risk factors for peripartum or postpartum stroke and intracranial venous thrombosis.
Methods—Data from the Healthcare Cost and Utilization Project were analyzed for the years 1993 and 1994. Observed values were weighted with poststratification discharge weights to project to the universe of all discharges from community hospitals located in the United States. Nationally representative estimates of risk were calculated on the basis of age, race, mode of delivery, income, third-party payer, hospital size, hospital ownership, hospital location (rural versus urban), hospital teaching status, census region, and presence of specific complications. Multivariate models were developed with the use of logistic regression.
Results—Among 1 408 015 sampled deliveries, there were 183 observed cases of peripartum stroke and 170 cases of peripartum intracranial venous thrombosis in 17 states in the United States in 1993 and 1994. There were an estimated 975 cases of stroke and 864 cases of intracranial venous thrombosis during pregnancy and the puerperium in the United States among 7 463 712 deliveries during 1993 and 1994, for estimated risks of 13.1 cases of peripartum stroke and 11.6 cases of peripartum intracranial venous thrombosis per 100 000 deliveries. Multivariate analysis showed that the following were strongly and significantly associated with both peripartum and postpartum stroke: cesarean delivery; fluid, electrolyte, and acid-base disorders; and hypertension. Covariates that were strongly and significantly associated with both peripartum and postpartum intracranial venous thrombosis included cesarean delivery, hypertension, and infections other than pneumonia and influenza.
Conclusions—Pregnancy-related hypertension and cesarean delivery are important risk factors for both stroke or intracranial venous thrombosis.
Key Words: cerebrovascular disorders • epidemiology • pregnancy • puerperium • risk factors
This article has been cited by other articles:
 |
|
 |
|
  B. A. Khealani, M. Wasay, M. Saadah, E. Sultana, S. Mustafa, F. S. Khan, and A. K. Kamal Cerebral Venous Thrombosis: A Descriptive Multicenter Study of Patients in Pakistan and Middle East Stroke, October 1, 2008; 39(10): 2707 - 2711. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Viguera, A. D. Emmerich, and L. S. Cohen Case 24-2008 -- A 35-Year-Old Woman with Postpartum Confusion, Agitation, and Delusions N. Engl. J. Med., July 31, 2008; 359(5): 509 - 515. [Full Text] [PDF]
|
|
|
|
 |
|
 S D Treadwell, B Thanvi, and T G Robinson Stroke in pregnancy and the puerperium Postgrad. Med. J., May 1, 2008; 84(991): 238 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C A Davie and P O'Brien Stroke and pregnancy J. Neurol. Neurosurg. Psychiatry, March 1, 2008; 79(3): 240 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. T. Zak, H. S. Dulai, and K. K. Kish Imaging of Neurologic Disorders Associated with Pregnancy and the Postpartum Period RadioGraphics, January 1, 2007; 27(1): 95 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kapessidou, M. Vokaer, M. Laureys, J. C. Bier, and J. G. Boogaerts Case report: Cerebral vein thrombosis after subarachnoid analgesia for labour: [Thrombose veineuse cerebrale a la suite d'une analgesie sous-arachnoidienne pour le travail obstetrical]. Can J Anesth, October 1, 2006; 53(10): 1015 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. W. Brown, N. Dueker, D. J. Jamieson, J. W. Cole, M. A. Wozniak, B. J. Stern, W. H. Giles, and S. J. Kittner Preeclampsia and the Risk of Ischemic Stroke Among Young Women: Results From the Stroke Prevention in Young Women Study Stroke, April 1, 2006; 37(4): 1055 - 1059. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. James, C. D. Bushnell, M. G. Jamison, and E. R. Myers Incidence and Risk Factors for Stroke in Pregnancy and the Puerperium Obstet. Gynecol., September 1, 2005; 106(3): 509 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Stam Thrombosis of the Cerebral Veins and Sinuses N. Engl. J. Med., April 28, 2005; 352(17): 1791 - 1798. [Full Text] [PDF]
|
|
|
|
|
|
A. Arxer, B. Pardina, I. Blas, L. Ramio, and A. Villalonga Dural sinus thrombosis in a late preeclamptic woman Can J Anesth, December 1, 2004; 51(10): 1050 - 1051. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Ferro, P. Canhao, J. Stam, M.-G. Bousser, F. Barinagarrementeria, and for the ISCVT Investigators Prognosis of Cerebral Vein and Dural Sinus Thrombosis: Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) Stroke, March 1, 2004; 35(3): 664 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. M. Callaghan and C. J. Berg Pregnancy-Related Mortality Among Women Aged 35 Years and Older, United States, 1991-1997 Obstet. Gynecol., November 1, 2003; 102(5): 1015 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. B. Nelson Can We Prevent Cerebral Palsy? N. Engl. J. Med., October 30, 2003; 349(18): 1765 - 1769. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Kimber Cerebral venous sinus thrombosis QJM, March 1, 2002; 95(3): 137 - 142. [Full Text] [PDF]
|
|
|
|
|
|
D. J. Lanska, C. Jaigobin, and F. Silver Re: Stroke and Pregnancy Response Stroke, July 1, 2001; 32(7): 1694 - 1695. [Full Text] [PDF]
|
|