Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
J Headache Pain. 2023 Dec 1;24(1):159. doi: 10.1186/s10194-023-01689-9.
Primary headache disorder is a known risk factor for stroke in women and usually improves during the first trimester of pregnancy. However, despite this, some women develop headaches during pregnancy (G-HA), and the effect of this headache on subsequent stroke is unknown. In this study, we evaluated the association between G-HA and stroke after delivery in women.
Based on the Korean National Health Insurance Service database, we included women hospitalized for delivery between 2012 and 2013. G-HA was defined as a headache diagnosed during pregnancy. Primary outcome was any stroke that occurred during the observational periods from delivery to December 31, 2020. All diseases were identified based on data registered in the database using the International Classification of Disease-10 Revision-Clinical Modification codes.
Of 906,187 pregnant women, G-HA was found in 56,813 (6.3%). During the observational periods, the G-HA ( +) group had a significantly higher risk of any stroke [adjusted hazard ratio (aHR) = 1.59, 95% confidence interval (CI): 1.30-1.95], ischemic stroke (aHR = 1.50, 95% CI: 1.12-2.01), hemorrhagic stroke (aHR = 1.63, 95% CI: 1.23-2.15), and intracerebral hemorrhage (aHR = 1.63, 95% CI: 1.19-2.23) than the G-HA (-) group. When analyzed considering the interaction with history of headache disorder, G-HA showed a significant association with hemorrhagic stroke, but lost its effect on ischemic stroke.
We demonstrated that G-HA was associated with subsequent stroke occurrence after delivery. However, the relationship between G-HA and ischemic stroke is mitigated by a history of pre-pregnancy headache disorder.
原发性头痛障碍是女性中风的已知危险因素，通常在妊娠早期会有所改善。然而，尽管如此，一些女性在怀孕期间仍会出现头痛（G-HA），并且这种头痛对随后中风的影响尚不清楚。在这项研究中，我们评估了 G-HA 与女性产后中风之间的关系。
基于韩国国家健康保险服务数据库，我们纳入了 2012 年至 2013 年住院分娩的女性。G-HA 定义为在怀孕期间诊断出的头痛。主要结局是在从分娩到 2020 年 12 月 31 日的观察期间发生的任何中风。所有疾病均根据数据库中注册的数据，使用国际疾病分类第 10 次修订版临床修正代码进行识别。
在 906187 名孕妇中，发现 56813 名（6.3%）患有 G-HA。在观察期间，G-HA（+）组发生任何中风的风险显著升高[调整后的危险比（aHR）=1.59，95%置信区间（CI）：1.30-1.95]、缺血性中风（aHR=1.50，95%CI：1.12-2.01）、出血性中风（aHR=1.63，95%CI：1.23-2.15）和脑内出血（aHR=1.63，95%CI：1.19-2.23）高于 G-HA（-）组。当分析考虑与头痛障碍病史的相互作用时，G-HA 与出血性中风显著相关，但对缺血性中风的影响减弱。
我们表明 G-HA 与产后中风的发生有关。然而，妊娠前头痛障碍史减轻了 G-HA 与缺血性中风之间的关系。
