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Predictors of Mortality and Functional Outcome in Pregnancy and Puerperium-Related Cerebral Venous Thrombosis

Maria Khan1, Antonio Arauz2, Derya Uluduz3

  • 1Rashid Hospital, Dubai, United Arab Emirates.

Cerebrovascular Diseases (Basel, Switzerland)
|December 25, 2022
PubMed

Insights

Cerebral venous thrombosis (CVT) during pregnancy and postpartum is linked to poor outcomes. Encephalopathy, infection, and anemia are key predictors of poor functional outcomes and mortality in these patients.

Area of Science:

  • Neurology
  • Obstetrics
  • Thrombosis Research

Background:

  • Cerebral venous thrombosis (CVT) during pregnancy and the postpartum period is a recognized complication.
  • Limited data exists on functional outcomes for this specific patient group.

Purpose of the Study:

  • To identify risk factors, clinical, imaging, and laboratory variables predicting functional outcome and mortality in pregnancy- and puerperium-related CVT.
  • To analyze predictors of poor functional outcome (modified Rankin score >2) and death within 30 days of CVT onset.

Main Methods:

  • A combined analysis of prospective CVT registries from Pakistan, Turkey, and Mexico.
  • Standardization of datasets and variables for demographic characteristics, presentation, risk factors, and outcomes.
  • Binary logistic regression was employed to determine predictors of outcome.

Main Results:

  • 553 cases of pregnancy/puerperium-related CVT were analyzed; 79.4% occurred postpartum.
  • Common obstetric risk factors included anemia (36.7%) and dehydration (22.9%).
  • Predictors of poor outcome (mRS >2) were encephalopathy, Mexican origin, fever/puerperal infection, and anemia. Encephalopathy and Mexican origin were associated with the highest mortality.

Conclusions:

  • Encephalopathy, fever/puerperal infection, and anemia are associated with adverse functional outcomes in pregnancy/puerperium-related CVT.
  • Encephalopathy and origin (Mexican) are linked to increased mortality within 30 days.
  • Anemia and infection are potentially reversible predictors that warrant clinical attention to improve patient outcomes.
Abstract

Keywords:
Cerebral venous thrombosisPregnancyPuerperiumStrokeWomen

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