Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-37, Atlanta, GA 30341-3724, USA.
Stroke. 2011 Sep;42(9):2564-70. doi: 10.1161/STROKEAHA.110.610592. Epub 2011 Jul 28.
Stroke is an important contributor to maternal morbidity and mortality, but there are no recent data on trends in pregnancy-related hospitalizations that have involved a stroke. This report describes stroke hospitalizations for women in the antenatal, delivery, and postpartum periods from 1994 to 1995 to 2006 to 2007 and analyzes the changes in these hospitalizations over time.
Hospital discharge data were obtained from the Nationwide Inpatient Sample, developed as part of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. Pregnancy-related hospitalizations with stroke were identified according to the International Classification of Diseases, Ninth Revision. All statistical analyses accounted for the complex sampling design of the data source.
Between 1994 to 1995 and 2006 to 2007, the rate of any stroke (subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, transient ischemic attack, cerebral venous thrombosis, or unspecified) among antenatal hospitalizations increased by 47% (from 0.15 to 0.22 per 1000 deliveries) and among postpartum hospitalizations by 83% (from 0.12 to 0.22 per 1000 deliveries) while remaining unchanged at 0.27 for delivery hospitalizations. In 2006 to 2007, ≈32% and 53% of antenatal and postpartum hospitalizations with stroke, respectively, had concurrent hypertensive disorders or heart disease. Changes in the prevalence of these 2 conditions from 1994 to 1995 to 2006 to 2007 explained almost all of the increase in postpartum hospitalizations with stroke during the same period.
Our results have demonstrated an increasing trend in the rate of pregnancy-related hospitalizations with stroke in the United States, especially during the postpartum period, from 1994 to 1995 to 2006 to 2007.
卒中是导致孕产妇发病率和死亡率升高的重要原因之一，但目前尚无近期妊娠相关卒中住院趋势的数据。本报告描述了 1994 年至 1995 年至 2006 年至 2007 年期间产前、分娩和产后期间因卒中住院的情况，并分析了这些住院情况随时间的变化。
从医疗保健成本和利用项目（由医疗保健研究和质量局赞助）的全国住院患者样本中获得住院数据。根据疾病国际分类第九版，确定与妊娠相关的卒中住院患者。所有统计分析均考虑了数据源的复杂抽样设计。
在 1994 年至 1995 年至 2006 年至 2007 年期间，产前住院卒中发生率（蛛网膜下腔出血、脑出血、缺血性卒中、短暂性脑缺血发作、脑静脉血栓形成或未特指）增加了 47%（从每 1000 次分娩的 0.15 增加到 0.22），产后住院卒中发生率增加了 83%（从每 1000 次分娩的 0.12 增加到 0.22），而分娩住院卒中发生率保持不变（每 1000 次分娩 0.27）。在 2006 年至 2007 年，分别有 32%和 53%的产前和产后卒中住院患者同时伴有高血压疾病或心脏病。1994 年至 1995 年至 2006 年至 2007 年期间，这两种疾病的患病率变化几乎解释了同期产后卒中住院患者增加的全部原因。
我们的结果表明，美国妊娠相关卒中住院率呈上升趋势，尤其是在 1994 年至 1995 年至 2006 年至 2007 年期间产后期间。
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