Ischemic stroke in young women
- 25 July 2000
- journal article
- Published by Wolters Kluwer Health in Neurology
- Vol. 55 (2) , 269-274
- https://doi.org/10.1212/wnl.55.2.269
Abstract
Objective: To assess whether subsequent pregnancies increase the risk of recurrent stroke and whether the occurrence of an ischemic stroke affects reproductive history. Methods: The authors identified 489 consecutive women aged 15 to 40 years with a first-ever arterial ischemic stroke or cerebral venous thrombosis from the record system of nine French neurologic centers. Information on stroke recurrence and reproductive history was obtained by means of chart review, written questionnaire, and telephone interview. Results: Data were analyzed from 441 women (373 with arterial ischemic stroke and 68 with cerebral venous thrombosis). During a mean follow-up of 5 years, 13 arterial recurrent ischemic strokes occurred. There were no cases of recurrent cerebral venous thrombosis. The overall risk of recurrence was 1% within 1 year and 2.3% within 5 years. The risk of recurrence was significantly higher in patients with stroke of definite cause. Eleven recurrent strokes occurred outside pregnancy (absolute risk of recurrence = 0.5%; 95% CI 0.3, 0.95) and two during pregnancy or the puerperium (absolute risk of recurrence = 1.8%; 95% CI 0.5, 7.5). The relative risk of recurrence was significantly higher during the postpartum period (risk ratio = 9.7; 95% CI 1.2, 78.9) than during pregnancy (risk ratio = 2.2; 95% CI 0.3, 17.5) itself. The outcome of the 187 subsequent pregnancies was similar to that expected from the general population. Thirty-four percent of women indicated that they would have desired more pregnancies after their initial stroke. The main reasons for not considering pregnancy were concern of a recurrent stroke, medical advice against pregnancy, and residual handicap. Conclusion: Young women with a history of ischemic stroke have a low risk of recurrence during subsequent pregnancies. The postpartum period, not the pregnancy itself, is associated with an increased risk of recurrent stroke. The outcome of pregnancies in these women appears to be similar to that expected in the general population. A previous ischemic stroke is not a contraindication to a subsequent pregnancy.Keywords
This publication has 23 references indexed in Scilit:
- Peripartum stroke and intracranial venous thrombosis in the National Hospital discharge surveyPublished by Wolters Kluwer Health ,1998
- Incidence of Stroke and Myocardial Infarction in Women of Reproductive AgeStroke, 1997
- Incidence and Causes of Strokes Associated With Pregnancy and PuerperiumStroke, 1995
- Prognosis after transient ischemic attack and ischemic stroke in young adults.Stroke, 1994
- Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project.Stroke, 1994
- Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.BMJ, 1993
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993
- Long-term prognosis of ischemic stroke in young adultsActa Neurologica Scandinavica, 1992
- Incidence of stroke in young adults in Florence, Italy.Stroke, 1988
- Cerebral thromboembolism among young women and men in Denmark 1977-1982.Stroke, 1986