Pregnancy and the risk of stroke
Pregnancy and the risk of stroke
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DOI：
10.1056/nejm199609123351102
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发表时间：
1996-09-12
影响因子：
158.5
通讯作者：
Wozniak, MA
中科院分区：
文献类型：
--
作者：
Kittner, SJ;Stern, BJ;Wozniak, MA
背景人们普遍认为怀孕会增加中风的风险，但很少有数据可以量化这种风险。方法我们确定了马里兰州中部和华盛顿，华盛顿特区的所有15至44岁的女性患者，在1988年或1991年从研究地区的46家医院中的任何一家出院。两名神经科医生使用妇女医疗记录中的数据对每个病例进行了审查。我们确定了这些妇女在中风发生时或中风发生前六周内是否怀孕。为了这项分析的目的，怀孕后的六个星期内，可以开始与人工流产或自然流产或交付的活产或死胎child.Results 17脑梗死和14脑内出血发生在妇女谁是或最近已经怀孕（妊娠相关中风），有175脑梗死和48脑内出血是不相关的怀孕。对于脑梗死，怀孕期间的相对风险，经年龄和种族调整后，为0.7（95%置信区间，0.3至1.6），但产后期间（活产或死产后）增加至8.7（95%置信区间，4.6至16.7）。对于脑内出血，调整后的相对危险度在怀孕期间为2.5（95%置信区间，1.0至6.4），但在产后期间为28.3（95%置信区间，13.0至61.4）。总的来说，对于妊娠期间或妊娠后6周内的任何一种中风，调整后的相对危险度为2.4（95%可信区间为1.6 ~ 3.6），可归因或超额风险为每10万例妊娠中8.1例中风（95%置信区间，6.4至9.7）结论脑梗死和脑出血的危险性在产后6周内增加，而在妊娠期无明显变化。本身(C)1996年，马萨诸塞州医学会。
Background It is widely believed that pregnancy increases the risk of stroke, but there are few data available to quantify that risk.Methods We identified all female patients 15 through 44 years of age in central Maryland and Washington, D.C., who were discharged from any of 46 hospitals in the study area in 1988 or 1991. Two neurologists reviewed each case, using data from the women's medical records. We determined whether the women had been pregnant at the time of the stroke or up to six weeks before it occurred. For purposes of this analysis, the six-week period after pregnancy could begin with an induced or spontaneous abortion or with the delivery of a live or stillborn child.Results Seventeen cerebral infarctions and 14 intracerebral hemorrhages occurred in women who were or had recently been pregnant (pregnancy-related strokes), and there were 175 cerebral infarctions and 48 intracerebral hemorrhages that were not related to pregnancy. For cerebral infarction, the relative risk during pregnancy, adjusted for age and race, was 0.7 (95 percent confidence interval, 0.3 to 1.6), but it increased to 8.7 for the postpartum period (after a live birth or stillbirth) (95 percent confidence interval, 4.6 to 16.7). For intracerebral hemorrhage, the adjusted relative risk was 2.5 during pregnancy (95 percent confidence interval, 1.0 to 6.4) but 28.3 for the postpartum period (95 percent confidence interval, 13.0 to 61.4). Overall, for either type of stroke during or within six weeks after pregnancy, the adjusted relative risk was 2.4 (95 percent confidence interval, 1.6 to 3.6), and the attributable, or excess, risk was 8.1 strokes per 100,000 pregnancies (95 percent confidence interval, 6.4 to 9.7).Conclusions The risks of both cerebral infarction and intracerebral hemorrhage are increased in the six weeks after delivery but nor during pregnancy itself. (C) 1996, Massachusetts Medical Society.