Pregnancy-associated stroke -a systematic review of subsequent pregnancies and maternal health

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Karjalainen , L , Tikkanen , M , Rantanen , K , Laivuori , H , Gissler , M & Ijäs , P 2019 , ' Pregnancy-associated stroke -a systematic review of subsequent pregnancies and maternal health ' , BMC Pregnancy and Childbirth , vol. 19 , 187 .

Title: Pregnancy-associated stroke -a systematic review of subsequent pregnancies and maternal health
Author: Karjalainen, Liisa; Tikkanen, Minna; Rantanen, Kirsi; Laivuori, Hannele; Gissler, Mika; Ijäs, Petra
Contributor organization: Clinicum
Neurologian yksikkö
HUS Neurocenter
Department of Obstetrics and Gynecology
HUS Gynecology and Obstetrics
Institute for Molecular Medicine Finland
Pregnancy and Genes
Department of Medical and Clinical Genetics
Helsinki Institute of Life Science HiLIFE
Genomics of Neurological and Neuropsychiatric Disorders
Date: 2019-05-28
Language: eng
Number of pages: 10
Belongs to series: BMC Pregnancy and Childbirth
ISSN: 1471-2393
Abstract: BackgroundPregnancy-associated stroke is a rare but life-threatening event, with an estimated incidence of 30/100000 deliveries. Data on the risk of stroke recurrence and the risk of other adverse pregnancy outcomes are essential for adequate counselling and surveillance in subsequent pregnancies. The aim of this systematic review is to describe the implications of a pregnancy-associated stroke for the future health of these women.MethodsWe searched Ovid Medline, PubMed, Cochrane Library and CINAHL for articles published in 1980-2018. Articles including women with pregnancy-associated stroke and information on at least one of the following outcomes were included: 1) recurrence of stroke during subsequent pregnancy, 2) number and course of subsequent pregnancies and their outcomes and 3) subsequent cardiovascular health.ResultsTwelve articles were included in the review, with six providing information on subsequent pregnancies, four on subsequent maternal health and two on both. The included articles varied greatly in terms of study design, length of follow up and reported outcomes. We found 252 women with pregnancy-associated stroke for whom the outcomes of interest were reported: 135 women with information on subsequent pregnancies and 123 women with information on future health. In total, 55 pregnancies after stroke were found. In the majority of studies, the incidence of pregnancy complications was comparable to that of the general population. The risk of stroke recurrence during pregnancy was 2%. Data on subsequent health of these women were limited, and the quality of the data varied between the studies.ConclusionsData on subsequent pregnancies and health of women with a history of pregnancy-associated stroke are limited. Further research on this topic is essential for adequate counselling and secondary prevention.
Subject: Stroke
Postpartum period
Pregnancy-associated stroke
Subsequent pregnancies
Pregnancy outcome
Future health
Cardiovascular disease
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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