Pregnancy and Stroke: Insight From the Cosmos Database

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Public Health

Background:

• Maternal stroke is an uncommon yet severe complication during pregnancy.
• This study investigates the incidence, trends, and outcomes of maternal stroke in the United States.

Purpose of the Study:

• To assess the incidence and temporal trends of maternal stroke.
• To evaluate maternal and neonatal outcomes associated with pregnancy-related stroke.
• To identify risk factors and trends in maternal stroke.

Main Methods:

• Retrospective analysis of electronic health records from January 2016 to January 2024.
• Inclusion of over 5.4 million pregnancies from the Cosmos Epic database.
• Propensity score matching used to adjust for confounding factors in outcome analysis.

Main Results:

• Maternal stroke incidence was 48.8 per 100,000 pregnancies, with ischemic stroke showing an upward trend.
• Stroke patients were older, more likely to be Black, and had higher rates of comorbidities like hypertension and eclampsia.
• The stroke group experienced higher mortality, delivery complications, lower birth weight, and longer neonatal hospital stays.

Conclusions:

• Maternal stroke, while rare, poses significant risks to both mother and child.
• The rising incidence of ischemic stroke highlights the need for enhanced preventive measures.
• Multidisciplinary perinatal care is crucial for managing maternal stroke effectively.