Liang Zhu-Wei, Lin Li, Gao Wan-Li, Feng Li-Min
Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
Sci Rep. 2015 Mar 30;5:9509. doi: 10.1038/srep09509.
Intracerebral haemorrhage (ICH) occurring during pregnancy and the puerperium is an infrequent but severe complication with a high mortality and poor prognosis. Until recently, previous studies have mainly focused on the effect of different treatments on prognosis. However, few studies have provided solid evidence to clarify the key predisposing factors affecting the prognosis of ICH. In the present study, based on a unique sample with a high ICH incidence and mortality rate, we described the main clinical characteristics of ICH patients and found that the prognosis of patients who underwent surgical intervention was not better than that of patients who received other treatment modalities. However, pre-eclampsia patients had higher maternal and neonatal mortality rates than other aetiology groups. Furthermore, univariate regression analysis identified onset to diagnosis time (O-D time) and pre-eclampsia as the only factors showing independent correlation with poor maternal outcomes (modified Rankin Scale, mRS ≥ 3), and only O-D time was identified as a predictor of maternal mortality. These results revealed that the aetiology of ICH and O-D time might be crucial predisposing factors to prognosis, especially for patients with pre-eclampsia. The study highlighted a novel direction to effectively improve the prognosis of pregnancy-associated ICH.
妊娠和产褥期发生的脑出血（ICH）是一种罕见但严重的并发症，死亡率高且预后不良。直到最近，以往的研究主要集中在不同治疗方法对预后的影响上。然而，很少有研究提供确凿证据来阐明影响ICH预后的关键诱发因素。在本研究中，基于一个ICH发病率和死亡率较高的独特样本，我们描述了ICH患者的主要临床特征，发现接受手术干预的患者的预后并不优于接受其他治疗方式的患者。然而，子痫前期患者的孕产妇和新生儿死亡率高于其他病因组。此外，单因素回归分析确定发病至诊断时间（O-D时间）和子痫前期是与不良孕产妇结局（改良Rankin量表，mRS≥3）呈独立相关的唯一因素，且只有O-D时间被确定为孕产妇死亡的预测因素。这些结果表明，ICH的病因和O-D时间可能是影响预后的关键诱发因素，尤其是对子痫前期患者而言。该研究为有效改善妊娠相关ICH的预后指明了一个新方向。
