Abstract WP183: Pregnancy-related Factors Associated With Stroke In Mothers And Newborns: Data From The International Maternal Newborn Stroke Registry

Abstract

Background: Maternal and newborn stroke occur during the same period when physiological and anatomic connections between mother and infant may provide a rationale for common pathogenetic mechanisms. The similarities and differences between maternal and newborn stroke remain poorly understood. We created the International Maternal Newborn Stroke Registry - the first database to explore these relationships. Methods: Eleven international sites participated; 9 enrolled cases for this analysis. Eligible cases were newborns (from 28 weeks gestation to 28 postnatal days) or mothers (peripartum or within 6 weeks postpartum) diagnosed with stroke (ischemic, hemorrhagic, cerebral sinovenous thrombosis). Preterm infants (< 28 weeks gestation) and neonates with germinal matrix/intraventricular hemorrhage were excluded. Descriptive statistics were performed to compare stroke sub-types, demographic and pregnancy-related risk factors. Results: We enrolled 103 cases, 69 newborn and 34 maternal. Median maternal age was 29 years (IQR 25-36) for the maternal group and 32 years (IQR 30-36) for the neonatal group. Women with maternal strokes were more likely to have pre-eclampsia (15%) and migraine (44%). Compared to maternal strokes, newborn strokes occurred more often in women from urban locations, were ischemic, and were less likely to be associated with alcohol use and pre-eclampsia during pregnancy (Table). Conclusion: In this novel registry, we describe factors that impact both maternal and newborn stroke. Urban area of residence and maternal age > 30 were associated with newborn strokes, while migraine and pre-eclampsia were strongly associated with maternal strokes. Differing mechanisms and stroke subtypes may explain these differences. In addition, lack of access to healthcare in certain geographical locations may lead to under-identification. Further research is needed to determine if these results are consistent when applied to a larger sample size.