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Rehabilitation Practice and Science

Translated Title

懷孕期間發生腦中風之預後

Abstract

Background: This study focused on the differences in incidence, mortality, epidemiology, causes, risk factors, severity, and prognosis between two groups of patients; a stroke-during-pregnancy (SDP) group and a stroke-of-young-female (SYF) group with similar physical status. We investigated whether pregnancy was a contributing factor to stroke, and reviewed the maternal characteristics and fetal outcome for patients suffering from stroke during pregnancy.Methods: Based on a restrospective analysis of stroke occurring during pregnancy and in young female patients during the 8-year period from January 1991 to February 1999 at Kaohsiung ST. Joseph Hospital and Chang-Gung Hospital. In both groups, all patients underwent diagnostic procedures, including history taking, neurological examination, extensive laboratory testing, and neuroimaging studies. Also included were the obstetric histories and complications of the SDP group. Results: During this 8-year period, there were 11 stroke patients among 31175 pregnant women, yielding an incidence of about 0.035 % in the SDP group. At the same time, there were 32558 stroke patients, including 349 young women, with an incidence of 1.1 % in the SYF group. Both groups had high mortality rates (about 18 %). Compared with the SYF group, the SDP group was younger (28.5 vs 34.0 years, P ＜ 0.001), and had higher rates of consciousness changes (64% vs 28%) and seizures (55% vs 6%) as initial stroke symptoms. However, there were no significant differences in other aspects, such as mortality rate, type of stroke, motor impairment and recovery, complication rate and average number of admission days. Moreover, the babies of the SDP group had a higher mortality rate (9% vs 0.67%) and lower birth weight (2.5 vs 3.4 kg) than Taiwanese newborns in general. This combined with low Apgar scores and low maternal coma scale scores among the patients having emergent cesarean deliveries. Conclusions: Although stroke in both groups caused high mortality and morbidity, the pregnancy factor did not cause increased severity in a majority of aspects. There were similar prognoses among SYF patients for neurological sequelae and functional status in this study, whether the patient was pregnant or not.

Language

English

First Page

131

Last Page

140

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