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Rate of hospitalization for pregnancy-related stroke jumps 50% over 12 years

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The greatest increase is seen during the postpartum period. What can you do to lower a patient’s risk?


 

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Stroke may be an unusual event in pregnancy, but it’s becoming less of a rarity, according to a new study.1 Hospitalizations related to stroke in pregnancy increased 54% over the past dozen years, from 4,085 in 1994–95 to 6,293 in 2006–07.

Researchers from the Centers for Disease Control and Prevention (CDC) analyzed a large national database of 5 to 8 million discharges from 1,000 hospitals and compared the rates of stroke from 1994–95 with the rates from 2006–07 in women who were pregnant, delivering a baby, and who had recently given birth.

In women who were pregnant, the rate of hospitalization for stroke rose 47%. The rate during the 12 weeks after delivery rose 83%. The rate remained stable for hospitalizations that occurred during the time immediately surrounding childbirth.

“I am surprised at the magnitude of the increase, which is substantial,” said Elena V. Kuklina, MD, PhD, lead author of the study and senior service fellow and epidemiologist at the CDC’s Division for Heart Disease and Stroke Prevention in Atlanta, Ga. “Our results indicate an urgent need to take a closer look. Stroke is such a debilitating condition. We need to put more effort into prevention.”

“Now more and more women entering pregnancy already have some type of risk factor for stroke, such as obesity, chronic hypertension, diabetes, or congenital heart disease. Since pregnancy by itself is a risk factor, if you have one of these other stroke risk factors, it doubles the risk.”

Not surprisingly, the prevalence of high blood pressure also rose over the 12-year period. In 1994–95, the rate was:

  • 11.3% in antepartum women
  • 23.4% in women at or near delivery
  • 27.8% in women within 12 weeks after delivery.

In 2006–07, the rate was:

  • 17% in antepartum women
  • 28.5% in women at or near delivery
  • 40.9% in women within 12 weeks after delivery.

“It’s best for women to enter pregnancy with ideal cardiovascular health, without additional risk factors,” Kuklina said. She recommends development of a comprehensive, multidisciplinary plan that gives doctors and patients guidelines for appropriate monitoring and care before, during, and after childbirth.

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