Long-Term Risk of Recurrent Cervical Artery Dissection and Stroke After Pregnancy.

Area of Science:

• Neurology
• Cardiovascular Medicine
• Reproductive Health

Background:

• Cervical artery dissection (CeAD) is a significant cause of stroke in young individuals.
• The risk of recurrent CeAD, stroke, or death following pregnancy in women with a history of CeAD remains unclear.

Purpose of the Study:

• To compare the incidence of a composite outcome (recurrent CeAD, stroke, or death) in women who became pregnant after CeAD versus those who did not.
• To evaluate the association between subsequent pregnancies and adverse cerebrovascular or mortality events after an initial CeAD.

Main Methods:

• An international, multicenter registry-based cohort study (LONG-RECAP) analyzed data from 1013 female CeAD patients.
• Follow-up data, including subsequent pregnancies and outcome events, were collected for at least 6 months post-CeAD.
• Cox proportional hazards regression was used to assess the association between pregnancy and outcomes, with and without age adjustment.

Main Results:

• Of 1013 women, 114 (11.3%) became pregnant after CeAD.
• The composite outcome occurred in 8.8% of the pregnancy group versus 7.2% of the non-pregnancy group (age-adjusted hazard ratio, 0.77; 95% CI, 0.38-1.56).
• No statistically significant increase in risk for the composite outcome or its individual components (recurrent CeAD, stroke, death) was observed in the pregnancy group.

Conclusions:

• Subsequent pregnancy after cervical artery dissection is not associated with an elevated risk of recurrent CeAD, stroke, or death.
• These findings provide crucial information for counseling women with a history of CeAD regarding family planning.
• The study suggests that pregnancy can be a safe option for many women with prior CeAD.