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Impact of Pre-eclampsia/eclampsia on Hemorrhagic and Ischemic Stroke Risk: A 17 years Follow-up Nationwide Cohort Study
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  • Chi-Jou Chuang,
  • Wen-Yen Chiou,
  • Hsuan-Ju Yang,
  • Shih-Kai Hung,
  • Moon-Sing Lee,
  • Liang-Cheng Chen,
  • Chia-Hui Chew,
  • Ben-Hui Yu,
  • Feng-Chun Hsu,
  • Hon-Yi Lin
Chi-Jou Chuang
Dalin Tzu Chi Hospital
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Wen-Yen Chiou
Dalin Tzu Chi Hospital
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Hsuan-Ju Yang
Dalin Tzu Chi Hospital
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Shih-Kai Hung
Tzu Chi University
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Moon-Sing Lee
Dalin Tzu Chi Hospital
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Liang-Cheng Chen
Dalin Tzu Chi Hospital
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Chia-Hui Chew
Dalin Tzu Chi Hospital
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Ben-Hui Yu
Dalin Tzu Chi Hospital
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Feng-Chun Hsu
Dalin Tzu Chi Hospital
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Hon-Yi Lin
Dalin Tzu Chi Hospital
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Abstract

Objective No study ever investigated the long-term risk of stroke in women with pre-eclampsia/eclampsia. The purpose of this study is to explore long-term stroke risks, differentiating subtypes and their time trends. Design Nationwide population-based cohort study Methods Between 2000 and 2017, 1,384,427 pregnant women were registered in the National Health Insurance Research Database in Taiwan. After excluding women with previous stroke history and exact matching with all confounders, 6,053 women with pre-eclampsia/eclampsia and 24,212 controls were recruited. Main Outcome Measures Hemorrhagic and ischemic strokes after child-birth Results Over the 17-year follow-up, the adjusted hazard ratio (aHR) for stroke in women with a history of pre-eclampsia/eclampsia was 2.05 (95% confidence interval, CI = 1.67-2.52, p<0.001). The 17 years overall risks of both ischemic and hemorrhagic stroke were 1.98 and 3.45, respectively (p<0.001). The stroke subtypes, hemorrhagic and ischemic, had different time trend risks, and hemorrhagic stroke risks kept higher than that of ischemic stroke. The ischemic stroke risk peaked during 1-3 years after childbirth (aHR=3.09). The hemorrhagic stroke risk peaked during 3-5 years (aHR=7.49). Conclusions Stroke risk persisted even after decades, for both ischemic and hemorrhagic subtypes. Women with pre-eclampsia/eclampsia history should be aware of the long-term risk of stroke. Tweetable abstract Both ischemic and hemorrhagic stroke risks persisted high even after decades, while their time trend risks were different. Keywords: pre-eclampsia/eclampsia; ischemic stroke; hemorrhagic stroke
24 Nov 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
25 Nov 2021Assigned to Editor
25 Nov 2021Submission Checks Completed
03 Dec 2021Reviewer(s) Assigned
19 Dec 2021Review(s) Completed, Editorial Evaluation Pending