Abstract WP199: Outcome of Pregnancies and Deliveries Before and After Ischemic Stroke- A Retrospective Matched Cohort Study

Abstract

Introduction: Limited data exist on the outcome of pregnancies and deliveries among young women with ischemic stroke. Hypothesis: The incidence of pregnancy- and delivery-related complications in women who will suffer or have suffered an ischemic stroke differs from stroke-free controls. Methods: We included young female patients admitted for an ischemic stroke to the Department of Neurology, Helsinki University Central Hospital 1994-2007, with pregnancy data before or after stroke recorded in the Medical birth Register (MBR) (n=154), and their stroke-free controls matched with age, parity, year of birth, residential area, and multiple pregnancies (n=616). We obtained data 1987-2014 on pregnancies from the MBR, all-cause hospitalizations from the Hospital Discharge Register, and causes of deaths from Statistics Finland. We used Poisson regression mixed models to compare the incidence of pregnancy- and delivery-related complications over time both before and after stroke. Results: Among a total of 1400 singleton pregnancies and deliveries, the incidence rate ratio (IRR) for the composite outcome, including pre-eclampsia, eclampsia, small for gestational age, low birth weight, preterm birth, placental abruption, gestational diabetes, hospital care during pregnancy, death of the mother during pregnancy or puerperium, stillbirth, early neonatal death, Apgar at 1 minute 6 or less, and if the child was not at home at 7 days from the delivery, was 1.29 (95% confidence interval (CI) 1.00-1.65) for the mother with an impending stroke, or a history of stroke, or both, compared with the matched control mother. Similar results were obtained if the data were restricted to those women who became pregnant before or after stroke (IRR 1.25 and IRR 1.34, respectively). When adjusted for smoking and socioeconomic status, the IRR for the composite outcome was 1.31 (95% CI 0.99-1.73). Conclusions: There was a slight increase in the incidence of pregnancy- and delivery-related complications over time for mothers with an impending stroke, or a history of stroke, or both, compared with stroke-free mothers.