Oral Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Pregnancy outcomes in women with a history of stroke (#64)

Kathryn E Austin 1 2 3 , Ibinabo Ibiebele 1 , Jane B Ford 1 , Sean Seeho 1 4 , Siranda Torvaldsen 1
  1. Clinical and Population Perinatal Health Research, Kolling Institue, University of Sydney, St Leonards, NSW, Australia
  2. Maternal Fetal Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
  3. Maternal Fetal Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia
  4. Royal Hospital for Women Sydney, St Leonards, NSW, Australia

 

ABSTRACT

Background: Little is known about the pregnancy outcomes of women who have had a stroke prior to a first pregnancy.

Aim: To identify a cohort of nulliparous women giving birth to a single baby and compare the pregnancy outcomes of those with a pre-pregnancy stroke hospitalisation record to those without a stroke hospitalisation record.

Method: Data linkage study of all nulliparous women aged 15–44 years with singleton pregnancies birthing in New South Wales from 2003–2015. Stroke was identified from 2001–2015 hospital data using ICD10-AM codes I60–64. Women whose first hospital record of stroke was during pregnancy or <42 days after birth were excluded. Outcomes included any diabetes or hypertension during pregnancy, mode of delivery, postpartum haemorrhage, severe maternal morbidity (validated composite outcome indicator), gestational age at birth, 5 minute Apgar score and health service utilisation.

Results: Of 487,767 women with a first pregnancy, 124 (2.5/10,000) had a hospital record which included a pre-pregnancy stroke diagnosis. Women with a stroke history were more likely to have a caesarean without labour (31% vs. 11%, P<0.0001) but no more likely to have a caesarean after the onset of labour (20% in each group). There were no significant differences in other maternal or neonatal outcomes.

Conclusion: This is the largest reported study of pregnancy and birth outcomes for women with a history of stroke. With the exception of pre-labour caesareans, there were no differences in pregnancy outcomes for women with a history of stroke compared with women with no history of stroke. These results should reassure women with a history of stroke who are pregnant or considering a pregnancy and assist in pre-conception counselling and future fertility planning.