Incidence and Time Trends of Pregnancy-Related Stroke Between 2010 and 2018: The Nationwide CONCEPTION Study
Yannick Béjot
(1, 2, 3, 4, 5, 6, 7)
,
Amélie Gabet
(1, 2, 3, 4, 5, 6, 7)
,
Clémence Grave
(1, 2, 3, 4, 5, 6, 7)
,
Nolwenn Regnault
(1, 2, 3, 4, 5, 6, 7)
,
Edouard Chatignoux
(1, 2, 3, 4, 5, 6, 7)
,
Elodie Moutengou
(1, 2, 3, 4, 5, 6, 7)
,
Catherine Deneux-Tharaux
(1, 2, 3, 4, 5, 6, 7)
,
Sandrine Kretz
(1, 2, 3, 4, 5, 6, 7)
,
Claire Mounier Vehier
(1, 2, 3, 4, 5, 6, 7, 8)
,
Vassilis Tsatsaris
(1, 2, 3, 4, 5, 6, 7)
,
Geneviève Plu-Bureau
(1, 2, 3, 4, 5, 6, 7)
,
Jacques Blacher
(1, 2, 3, 4, 5, 6, 7)
,
Valérie Olié
(1, 2, 3, 4, 5, 6, 7)
1
UB -
Université de Bourgogne
2 Université Lille Nord (France)
3 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
4 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
5 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
6 EPOPé [CRESS - U1153 / UMR_A 1125] - Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique
7 Université Paris Descartes, Sorbonne Paris Cité
8 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
2 Université Lille Nord (France)
3 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
4 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
5 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
6 EPOPé [CRESS - U1153 / UMR_A 1125] - Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique
7 Université Paris Descartes, Sorbonne Paris Cité
8 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Yannick Béjot
- Fonction : Auteur
Amélie Gabet
- Fonction : Auteur
Clémence Grave
- Fonction : Auteur
Nolwenn Regnault
- Fonction : Auteur
Edouard Chatignoux
- Fonction : Auteur
Elodie Moutengou
- Fonction : Auteur
Catherine Deneux-Tharaux
- Fonction : Auteur
Sandrine Kretz
- Fonction : Auteur
Claire Mounier Vehier
- Fonction : Auteur
Vassilis Tsatsaris
- Fonction : Auteur
Geneviève Plu-Bureau
- Fonction : Auteur
- PersonId : 1187826
- ORCID : 0000-0002-1020-8142
- IdRef : 031956092
Jacques Blacher
- Fonction : Auteur
Valérie Olié
- Fonction : Auteur
Résumé
ackground and Objectives
Despite the potentially devastating effects of pregnancy-related stroke, few studies have examined its incidence by type of stroke. We aimed to study the nationwide incidence rates and recent temporal trends for all types of pregnancy-related stroke and to compare these incidences with stroke incidence in nonpregnant women.
Methods
We conducted a study of 6,297,698 women aged 15–49 years who gave birth in France between 2010 and 2018 with no history of stroke before pregnancy by collecting data from the French National Health Insurance Information System database. Poisson regression was used to estimate the incidence by types of strokes for the different pregnancy periods and the incidence rate ratio of stroke in pregnant vs nonpregnant French women.
Results
Among the 6,297,698 women, 1,261 (24.0 per 100,000 person-years) experienced a first ever stroke during, antepartum peripartum, or the first 6 weeks of postpartum. Of the pregnancy-related strokes, 42.9% were ischemic (IS), 41.9% were hemorrhagic (with similar proportion of intracerebral and subarachnoid hemorrhage), and 17.4% were cerebral venous thrombosis (CVT). Compared with nonpregnant women, incidence rates of stroke were similar during pregnancy for IS (adjusted incidence risk ratio [IRR] 0.9 [0.8–1.1]), slightly higher for all hemorrhagic strokes (IRR 1.4 [1.2–1.8]), and considerably increased for CVT (IRR 8.1 [6.5–10.1]). Pregnancy-related stroke incidence rose between 2010 and 2018 for IS and HS but was stable for CVT.
Discussion
The risk of pregnancy-related CVT was more than 8-fold higher than that observed in nonpregnant women. The incidence of pregnancy-related IS and HS is increasing over time, and efforts should be made for prevention considering treatable cardiovascular risk factors and hypertensive disorders in pregnant women.