Severe preeclampsia (100% vs 70.5%, p<0.001), DVT/PE (OR 12.77), multiparity (OR 2.30), and recurrent preeclampsia (OR 2.18) were identified as significant risk factors for stroke in preeclampsia.
Case-Control (n=1,730)
Yes
Effect estimate: OR 12.77 (95% CI 3.07-53.12)
Abstract Background and aims Stroke is the leading cause of maternal death in preeclampsia. Still, factors contributing to stroke risk in preeclamptic patients are poorly documented. Our aims were to investigate stroke risk factors in preeclamptic patients. Methods This retrospective case-control study included 55 preeclamptic patients with stroke, identified from the Stroke in Pregnancy and Puerperium in Finland cohort during 1987-2016, using national healthcare registers. The control group comprised 1,675 preeclamptic patients without stroke from the Finnish Genetics of Preeclampsia Consortium cohort. Controls were recruited prospectively from hospitals during 2008-2011 and retrospectively from medical records during 1990-2008. Medical records were reviewed to verify diagnoses and collect clinical data. Results Significant risk factors for stroke among preeclamptic patients included advanced maternal age (OR 1.07, 95% Cl 1.02-1.13), multiparity (2.30, 1.30-4.09), recurrent preeclampsia (2.18, 1.17-4.07), severe preeclampsia (100.0% vs 70.5%, p0.001), and deep venous thrombosis/pulmonary embolism (12.77, 3.07-53.12). Cases had higher median peak systolic blood pressure (183 vs 165 mmHg; OR 1.036, 1.022–1.050), lactate dehydrogenase (446 vs 253 U/L; OR 1.001, 1.001–1.002), and alanine aminotransferase levels (35 vs 25 U/L; OR 1.002, 1.001–1.003) than controls. Preeclampsia occurred earlier in pregnancy in cases, although 23.6% had postpartum preeclampsia. Risk factors and clinical characteristics differed by stroke subtype. Conclusions Early occurrence of preeclampsia with severe features increases the risk of stroke, especially in older multiparous patients with recurrent preeclampsia or prior prothrombotic conditions. Sufficient screening of blood pressure and laboratory biomarkers enables early management and might decrease the stroke risk in preeclamptic patients. Conflict of interest The authors have nothing to disclose. Figure 1 - belongs to Results
Vest et al. (Fri,) conducted a case-control in Preeclampsia (n=1,730). Risk factors (including severe preeclampsia, DVT/PE, multiparity) vs. Preeclamptic patients without stroke was evaluated on Stroke (OR 12.77, 95% CI 3.07-53.12). Severe preeclampsia (100% vs 70.5%, p<0.001), DVT/PE (OR 12.77), multiparity (OR 2.30), and recurrent preeclampsia (OR 2.18) were identified as significant risk factors for stroke in preeclampsia.