Service de Médecine Interne, Unité Médecine Vasculaire, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.
Unité d'hémostase Clinique, Hôpital Cardiologique Louis Pradel, 5 Place d'Arsonval, 69003, Lyon, France.
Arch Gynecol Obstet. 2024 Jul;310(1):405-412. doi: 10.1007/s00404-024-07498-y. Epub 2024 Apr 29.
Although recurrence risk is a major concern for women having had an ischemic stroke (IS) and who are planning a pregnancy, studies on recurrence risk and pregnancy outcomes are scarce and heterogeneous.
This retrospective study assessed women aged 15-44 years with a diagnosis of ischemic stroke admitted in the Lyon Stroke Centre, France, between January 2009 and December 2013. The primary outcome was stroke recurrence during pregnancy or the post-partum period. Secondary outcomes were pregnancy complications.
Overall, 104 women with a prior ischemic stroke were included. Mean age at the time of the stroke was 36 ± 6.7 years old. Stroke etiology was large-artery atherosclerosis for 1 woman, cardioembolism for 23 women, and undetermined for 55 women. No antiphospholipid syndrome was found. Among them, 29 women had 58 subsequent pregnancies. Overall, there were three IS recurrence (2.9%), but none occurred during pregnancy. There were 27 miscarriages (47% of pregnancies), two pre-eclampsia (3%), and one stillbirth (1.7%).
We observed no recurrence of IS during pregnancy. The study also highlighted that the risk of miscarriages was higher than general population and that of stillbirth should be further studied.
尽管复发风险是曾患有缺血性中风（IS）并计划怀孕的女性的主要关注点，但关于复发风险和妊娠结局的研究很少且存在异质性。
本回顾性研究评估了 2009 年 1 月至 2013 年 12 月期间在法国里昂中风中心就诊的年龄在 15-44 岁之间、诊断为缺血性中风的女性。主要结局是妊娠或产后期间的中风复发。次要结局是妊娠并发症。
共有 104 例先前患有缺血性中风的女性纳入本研究。中风发生时的平均年龄为 36±6.7 岁。中风病因包括 1 例大动脉粥样硬化、23 例心源性栓塞和 55 例病因不明。未发现抗磷脂综合征。其中 29 例有 58 次后续妊娠。总体上有 3 例（2.9%）再次发生 IS，但均未发生在妊娠期间。有 27 例流产（47%的妊娠）、2 例先兆子痫（3%）和 1 例死胎（1.7%）。
我们未观察到妊娠期间 IS 的复发。该研究还强调，流产的风险高于一般人群，仍需进一步研究死胎的风险。
