Abstract

Background: Pregnancy-related stroke is a relatively uncommon yet devastating complication. However, the rates and associated risk factors of stroke in this context remain poorly described. Hypothesis: We aim to evaluate rates and associated risk factors for stroke. Methods: We conducted a population-based retrospective study using national inpatient data from 2016 to 2020 to assess ischemic stroke rates and identify associated risk factors during labor admissions. Regression analysis was performed, adjusting for multiple patient characteristics, to determine significant factors related to stroke occurrence. Results: We examined a total of 19,089,780 labor admissions. The incidence of ischemic stroke during labor admissions was recorded at a rate of 445 per 100,000 cases. Several factors showed significant associations with ischemic stroke in this context. Atrial fibrillation exhibited a strong correlation (odds ratio [OR] 5.98, 95% confidence interval [CI] [1.16-30.92], p=0.033), as did dyslipidemia (OR 9.54, 95% CI [4.38-20.80], p<0.001), heart failure (OR 3.95, 95% CI [1.09-14.34], p=0.037), chronic kidney disease (OR 6.27, 95% CI [1.92-20.47], p=0.002), cesarean section (OR 2.23, 95% CI [1.60-3.13], p<0.001), chronic hypertension (OR 1.67, 95% CI [1.12-2.47], p=0.011), and hypertensive disorders of pregnancy (OR 7.00, 95% CI [4.94-9.44], p<0.001). However, factors such as advanced maternal age, race/ethnicity, income quartile, gestational and non-gestational diabetes mellitus, coronary artery disease, tobacco use, polycystic ovarian syndrome, and peripartum cardiomyopathy did not exhibit significant associations with stroke. Conclusion: Our study highlights an incidence rate of 445 per 100,000 cases for pregnancy-related ischemic stroke during labor admissions and identified certain associated risk factors. These findings provide valuable guidance to healthcare professionals in identifying high-risk individuals.

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