Abstract
BackgroundThe incidence of female stroke has increased gradually and has begun occurring at a younger age in recent years. Given that women live longer than men, stroke would cause more negative and longer-term impacts on the rest of the lives of women. There are few related studies on Asian women. We aimed to evaluate stroke risk in Asian women following hypertensive pregnancy disorders.MethodsUsing the Taiwan National Health Insurance database, we designed a retrospective study that included pregnant women between 2000 and 2013. We selected an age-matched control group of women without hypertensive pregnancy disorders at a 1:3 ratio. The endpoint was any episode of stroke; otherwise, the patients were tracked until December 31, 2013. After the index date until the end of 2013, Cox proportional hazards analysis was used to compare the risk of incident stroke. The risk factors for stroke were determined using Cox proportional regression to calculate the hazard ratio (HR) compared with the control group.ResultsDuring the follow-up period, the Kaplan-Meier analysis indicated that patients with hypertensive pregnancy disorders had a significantly higher risk of developing stroke than did patients without hypertensive pregnancy disorders (log-rank test P < 0.001). Multivariate Cox regression analysis demonstrated that the case group had a 2.134-fold increased risk of stroke (HR = 2.134; 95% CI = 1.817–2.505; P < 0.001).ConclusionOur study provided evidence of an increased risk of stroke in patients with hypertensive pregnancy disorders. Compared with those without such disorders, the patients who had experienced the disorders had a 2.134-fold (P < 0.001) higher risk of developing stroke in the future.
Highlights
The incidence of female stroke has increased gradually and has begun occurring at a younger age in recent years
The Kaplan-Meier analysis indicated that patients with hypertensive pregnancy disorders had a significantly higher risk of developing stroke than did patients without hypertensive pregnancy disorders (Fig. 2)
The Cox regression analysis of the factors associated with the risk of stroke showed that the crude hazard ratio (HR) was 2.704
Summary
The incidence of female stroke has increased gradually and has begun occurring at a younger age in recent years. We aimed to evaluate stroke risk in Asian women following hypertensive pregnancy disorders. Hypertensive pregnancy disorders are a set of pregnancyspecific systemic diseases with a unique pathophysiology [1,2,3,4,5]. Hypertensive pregnancy disorders are critical risk factors for pregnancy-associated stroke [10]. They affect approximately 5% of pregnant women and increase the risk of pregnancy-associated cerebrovascular disease during the intrapartum and postpartum periods [11,12,13,14]. Cerebrovascular dysfunction related to hypertensive pregnancy disorders can lead to stroke, cerebral edema, seizures, and maternal mortality [10, 15, 16]
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