Impact of hypertensive disorders of pregnancy on short- and long-term outcomes of pregnancy-associated hemorrhagic stroke

Mei Fang; Jiayan Wang; Zexu Wang; Yuqi Chen; Wei Xu; Chuanyuan Tao; Lu Ma; Chao You; Xin Hu; Fan Xia

doi:10.3389/fneur.2023.1097183

Impact of hypertensive disorders of pregnancy on short- and long-term outcomes of pregnancy-associated hemorrhagic stroke

Front Neurol. 2023 Mar 16:14:1097183. doi: 10.3389/fneur.2023.1097183. eCollection 2023.

Authors

Mei Fang^{1

2}, Jiayan Wang^{1

2}, Zexu Wang², Yuqi Chen^{1

2}, Wei Xu¹, Chuanyuan Tao¹, Lu Ma¹, Chao You¹, Xin Hu¹, Fan Xia¹

Affiliations

¹ Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.

Abstract

Background and purpose: Though hypertension disorders of pregnancy (HDP) are recognized as independent pregnancy-associated stroke risk factors, few studies have considered their impact on stroke prognosis. Therefore, we intended to evaluate the impact of HDP on short- and long-term outcomes of pregnancy-associated hemorrhagic stroke (HS).

Methods: We conducted a retrospective analysis of patients admitted to our hospital from May 2009 to December 2021 with a diagnosis of pregnancy-associated HS. After dividing patients into two groups by the presence of a diagnosis of HDP or not, the short- (at the time of discharge) and long-term (after discharge follow-up) outcomes were compared by mRS (modified Rankin Scale) scores, and poor functional outcome defined as mRS > 2. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were reported.

Results: Twenty-two HDP and 72 non-HDP pregnancy-associated HS patients were enrolled and follow-up after 4.7 ± 3.6 years. There was no significant difference between the two groups regarding short-term outcomes, but patients with HDP were more likely to reach poor functional outcomes at long-term follow-up (aOR = 4.47, 95% CI = 1.28-15.67, p = 0.019).

Conclusions: In this retrospective study, women with hypertension disorders of pregnancy did not show worse short-term outcomes of pregnancy-associated hemorrhagic stroke compared to those without but had poorer long-term functional outcomes. This underlines the importance of prevention, recognition, and treatment of hypertension disorders in these women.

Keywords: eclampsia; hemorrhagic stroke; hypertensive disorders; outcome; preeclampsia; pregnancy.

Grants and funding

This work was supported by the 1·3·5 Projects for Disciplines of Excellence of West China Hospital of Sichuan University (grant numbers: ZY2016102 and 2021HXFH045), the National Natural Science Foundation of China (grant numbers: 81601155 and 82201453), the Sichuan Science and Technology Program (grant numbers: 2020YFQ0009 and 2023NSFSC1557), and the Project funded by China Postdoctoral Science Foundation (grant number: 2022M722271).