怀孕后出现的宫动脉解剖和中风的长期风险
Sandro K Fischer1,2, Josefin E Kaufmann1,2, Tiina M Metso3
1Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland.
JAMA network open
|July 17, 2025
概括
在宫动脉剖析 (CeAD) 后怀孕并没有增加女性复发CeAD,中风或死亡的风险. 这一发现支持对有CeAD病史的个体进行计划生育.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 生殖健康 生殖健康
背景情况:
- 宫动脉剖析 (CeAD) 是年轻人中风的重要原因之一.
- 患有CeAD史的妇女在怀孕后出现复发CeAD,中风或死亡的风险尚不清楚.
研究的目的:
- 为了比较复合结局 (复发的CeAD,中风或死亡) 在CeAD后怀孕的女性与没有怀孕的女性的发病率.
- 评估后续怀孕与首次CeAD后不良脑血管事件或死亡事件之间的关联.
主要方法:
- 一项基于多中心注册的国际队列研究 (LONG-RECAP) 分析了来自1013名女性CeAD患者的数据.
- 随访数据,包括随后的怀孕和结果事件,在CeAD后至少6个月内收集.
- 考克斯比例危险回归被用来评估怀孕和结果之间的关联,有或没有年龄调整.
主要成果:
- 在1013名女性中,114名 (11.3%) 在CeAD后怀孕.
- 综合结果发生在怀孕组的8.8%,而非怀孕组的7.2% (根据年龄调整的危险比率,0.77;95% CI,0.38-1.56).
- 在怀孕组中,没有观察到综合结果或其单个组件 (复发性CeAD,中风,死亡) 的风险显著增加.
结论:
- 宫动脉剖析后的随后怀孕与复发性CeAD,中风或死亡风险的增加无关.
- 这些发现为咨询有CeAD史的妇女提供了与计划生育有关的关键信息.
- 这项研究表明,怀孕对于许多以前患有CeAD的女性来说可能是安全的选择.
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