Document Detail


Ischemic stroke in young women: risk of recurrence during subsequent pregnancies. French Study Group on Stroke in Pregnancy.
MedLine Citation:
PMID:  10908903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether subsequent pregnancies increase the risk of recurrent stroke and whether the occurrence of an ischemic stroke affects reproductive history. METHODS: The authors identified 489 consecutive women aged 15 to 40 years with a first-ever arterial ischemic stroke or cerebral venous thrombosis from the record system of nine French neurologic centers. Information on stroke recurrence and reproductive history was obtained by means of chart review, written questionnaire, and telephone interview. RESULTS: Data were analyzed from 441 women (373 with arterial ischemic stroke and 68 with cerebral venous thrombosis). During a mean follow-up of 5 years, 13 arterial recurrent ischemic strokes occurred. There were no cases of recurrent cerebral venous thrombosis. The overall risk of recurrence was 1% within 1 year and 2.3% within 5 years. The risk of recurrence was significantly higher in patients with stroke of definite cause. Eleven recurrent strokes occurred outside pregnancy (absolute risk of recurrence = 0.5%; 95% CI 0.3, 0.95) and two during pregnancy or the puerperium (absolute risk of recurrence = 1. 8%; 95% CI 0.5, 7.5). The relative risk of recurrence was significantly higher during the postpartum period (risk ratio = 9.7; 95% CI 1.2, 78.9) than during pregnancy (risk ratio = 2.2; 95% CI 0. 3, 17.5) itself. The outcome of the 187 subsequent pregnancies was similar to that expected from the general population. Thirty-four percent of women indicated that they would have desired more pregnancies after their initial stroke. The main reasons for not considering pregnancy were concern of a recurrent stroke, medical advice against pregnancy, and residual handicap. CONCLUSION: Young women with a history of ischemic stroke have a low risk of recurrence during subsequent pregnancies. The postpartum period, not the pregnancy itself, is associated with an increased risk of recurrent stroke. The outcome of pregnancies in these women appears to be similar to that expected in the general population. A previous ischemic stroke is not a contraindication to a subsequent pregnancy.
Authors:
C Lamy; J B Hamon; J Coste; J L Mas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology     Volume:  55     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-15     Completed Date:  2000-08-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  269-74     Citation Subset:  AIM; IM    
Affiliation:
Service de Neurologie, Hôpital Sainte-Anne, Departement de Biostatistique et d'Informatique Médicale, Hôpital Cochin, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebral Veins
Female
Follow-Up Studies
Humans
Intracranial Embolism / diagnosis,  etiology
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis*,  etiology
Pregnancy Outcome
Puerperal Disorders / diagnosis,  etiology
Recurrence
Risk
Risk Factors
Stroke / diagnosis*,  etiology

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