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SiPP(妊娠和产后卒中):一项关于妊娠和产后妇女脑血管疾病病理生理机制、临床特征、管理及结局的前瞻性、观察性、国际性、多中心研究。

SiPP (Stroke in Pregnancy and Postpartum): A prospective, observational, international, multicentre study on pathophysiological mechanisms, clinical profile, management and outcome of cerebrovascular diseases in pregnant and postpartum women.

作者信息

Lorenzano Svetlana, Kremer Christine, Pavlovic Aleksandra, Jovanovic Dejana R, Sandset Else Charlotte, Christensen Hanne, Bushnell Cheryl, Arsovska Anita, Sprigg Nikola, Roffe Christine, Ijäs Petra, Gdovinova Zuzana, Alexandrov Anne, Zedde Marialuisa, Tassi Rossana, Acciaresi Monica, Lantz Maria, Sunnerhagen Katharina, Zarkov Marija, Rantanen Kirsi, Perren Fabienne, Iversen Helle K, Kruuse Christina, Slowik Agnieszka, Palazzo Paola, Korv Janika, Fromm Annette, Lovrencic-Huzjan Arijana, Korompoki Eleni, Fonseca Ana Catarina, Gall Seana L, Brunner Freimuth, Caso Valeria, Sacco Simona

机构信息

Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.

Neurology Department, Skåne University Hospital, Malmö, Sweden.

出版信息

Eur Stroke J. 2020 Jun;5(2):193-203. doi: 10.1177/2396987319893512. Epub 2019 Dec 6.

Abstract

RATIONALE

Cerebrovascular diseases associated with pregnancy and postpartum period are uncommon; however, they can have an important impact on health of both women and foetus or newborn.

AIMS

To evaluate the frequency, characteristics and management of cerebrovascular events in pregnant/postpartum women, to clarify pathophysiological mechanisms underlying the occurrence of these events including biomolecular aspects, and to assess the short- and long-term cerebrovascular and global cardiovascular outcome of these patients, their predictors and infant outcome.

METHODS AND DESIGN

This is an observational, prospective, multicentre, international case-control study. The study will include patients with cerebrovascular events during pregnancy and/or within six months after delivery. For each included case, two controls will be prospectively recruited: one pregnant or puerperal subject without any history of cerebrovascular event and one non-pregnant or non-puerperal subject with a recent cerebrovascular event. All controls will be matched by age, ethnicity and type of cerebrovascular event with their assigned cases. The pregnant controls will be matched also by pregnancy weeks/trimester. Follow-up will last 24 months for the mother and 12 months for the infant.

SUMMARY

To better understand causes and outcomes of uncommon conditions like pregnancy/postpartum-related cerebrovascular events, the development of multisite, multidisciplinary registry-based studies, such as the Stroke in Pregnancy and Postpartum study, is needed in order to collect an adequate number of patients, draw reliable conclusions and give definite recommendations on their management.

摘要

理论依据

与妊娠和产后期相关的脑血管疾病并不常见;然而,它们可能对女性以及胎儿或新生儿的健康产生重要影响。

目的

评估妊娠/产后女性脑血管事件的发生频率、特征及管理方式,阐明这些事件发生的病理生理机制,包括生物分子方面,并评估这些患者的短期和长期脑血管及整体心血管结局、其预测因素以及婴儿结局。

方法与设计

这是一项观察性、前瞻性、多中心、国际性病例对照研究。该研究将纳入在妊娠期间和/或分娩后六个月内发生脑血管事件的患者。对于每例纳入的病例,将前瞻性招募两名对照:一名无任何脑血管事件病史的妊娠或产后受试者,以及一名近期发生脑血管事件的非妊娠或非产后受试者。所有对照将按年龄、种族和脑血管事件类型与各自对应的病例进行匹配。妊娠对照还将按孕周/孕期进行匹配。对母亲的随访将持续24个月,对婴儿的随访将持续12个月。

总结

为了更好地理解妊娠/产后相关脑血管事件等罕见情况的病因和结局,需要开展多中心、多学科的基于登记处的研究,如妊娠和产后卒中研究,以便收集足够数量的患者,得出可靠结论并就其管理给出明确建议。

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本文引用的文献

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A review of stroke and pregnancy: incidence, management and prevention.中风与妊娠综述:发病率、管理与预防
Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181:20-7. doi: 10.1016/j.ejogrb.2014.07.024. Epub 2014 Jul 29.
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Risk of a thrombotic event after the 6-week postpartum period.产后 6 周后发生血栓事件的风险。
N Engl J Med. 2014 Apr 3;370(14):1307-15. doi: 10.1056/NEJMoa1311485. Epub 2014 Feb 13.

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