| Title: |
Long-Term Risk of Recurrent Cervical Artery Dissection and Stroke After Pregnancy |
| Authors: |
Fischer, Sandro K.; Kaufmann, Josefin E.; Metso, Tiina M.; Tatlisumak, Turgut; Wischmann, Johannes; Kellert, Lars; Mayer-Suess, Lukas; Knoflach, Michael; von Rennenberg, Regina; Nolte, Christian H.; Lee, Cheyenne; Aldridge, Chad M.; Worrall, Bradford B.; Weko, Andrew T.; Southerland, Andrew M.; Wiggins, Judea P.; Majersik, Jennifer J.; Baumgartner, Philipp; Wegener, Susanne; Metanis, Issa; Leker, Ronen R.; Cano-Nigenda, Vanessa; Arauz, Antonio; Frances, Anabella; Bozas, Ignacio; Martin, Juan J.; Zietz, Annaelle; Polymeris, Alexandros; Altersberger, Valerian L.; Abrignani, Giorgia; Castellini, Paola; Genovese, Antonio; Latte, Lilia; Trapasso, Maria Claudia; Zedde, Marialuisa; Bersano, Anna; Marinoni, Giulia; Silvestrelli, Giorgio; Baracchini, Claudio; Favruzzo, Francesco; Paciaroni, Maurizio; Spalloni, Alessandra; Patella, Rosalba; Cappellari, Manuel; Valletta, Francesco; Del Sette, Massimo; Sassos, Davide; Gentile, Mauro; Magoni, Mauro; Gamba, Massimo; Padroni, Marina; Azzini, Cristiano; Giorli, Elisa; Melis, Fabio; Tassi, Rossana; Calabro, Rocco Salvatore; Piras, Valeria; Melis, Maurizio; Giossi, Alessia; Sanguigni, Sandro; Mannino, Marina; Bignamini, Valeria; Gaiani, Alessandra; Adami, Alessandro; Bella, Rita; Pascarella, Rosario; Lyrer, Philippe; Gensicke, Henrik; Pezzini, Alessandro; Traenka, Christopher; Engelter, Stefan T. |
| Contributors: |
HUS Neurocenter; Neurologian yksikkö; University of Helsinki; Clinicum; Department of Neurosciences |
| Publisher Information: |
American Medical Association |
| Publication Year: |
2025 |
| Collection: |
Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| Subject Terms: |
Ischemic-stroke; Young-women; Postpartum; General medicine; internal medicine and other clinical medicine |
| Description: |
Importance Cervical artery dissection (CeAD) is a leading cause of stroke in young people and can occur during pregnancy. In women with prior CeAD, it is unclear whether future pregnancies increase the risk of recurrent CeAD, stroke, or death. Objective To compare the frequency of recurrent CeAD, stroke, or death as a composite outcome between patients with CeAD who became pregnant vs those who did not. Design, Setting, and Participants The Long-Term Risk of Recurrent Cervical Artery Dissection and Stroke After Pregnancy (LONG-RECAP) study was an international, multicenter, registry-based, explorative cohort study with data from May 1, 1990, and April 30, 2023, among patients with CeAD at 33 stroke centers across 9 countries who had at least 6 months of follow-up for whom detailed information was available on absence vs presence of subsequent pregnancies and the occurrence of outcome events. Exposure Pregnancy after CeAD. Main Outcomes and Measures Composite of recurrent CeAD, stroke (any type), and death (all causes) during follow-up at least 6 months after initial CeAD. Secondary outcomes were the components of the composite outcome. Cox proportional hazards regression analysis with and without adjustment for age was used to examine the association between pregnancy and outcomes. Results Among 1013 female patients with CeAD (median [IQR] age, 42 [35-48] years), 114 (11.3%) became pregnant during a median (IQR) follow-up of 5.3 (2.0-11.3) years. The composite outcome occurred in 10 of 114 patients (8.8%), including 7 patients with recurrent CeADs, 2 with ischemic strokes, and 1 with intracerebral hemorrhage, in the pregnancy group compared with 65 of 899 patients (7.2%), including 32 with recurrent CeAD, 26 with ischemic strokes, 4 with intracerebral hemorrhages, and 5 deaths (2 patients had 2 outcomes), in the nonpregnancy group (unadjusted hazard ratio, 1.08; 95% CI, 0.56-2.08; age-adjusted hazard ratio, 0.77; 95% CI, 0.38-1.56). Five of 10 events in the pregnancy group occurred post partum (4 CeADs and 1 ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISBN: |
978-0-01-531721-8; 0-01-531721-8 |
| Relation: |
This study was supported by a grant from the Swiss Heart Foundation (Drs Fischer, Traenka, and Engelter) and the Associazione per la Lotta alla Trombosi e alle Malattie Cardiovascolari (Dr Pezzini on behalf of the Italian Project on Stroke in Young Adults investigators).; https://hdl.handle.net/10138/599483; 105011774019; 001531721800001 |
| Availability: |
https://hdl.handle.net/10138/599483 |
| Rights: |
cc_by ; info:eu-repo/semantics/openAccess ; openAccess |
| Accession Number: |
edsbas.1CE4628B |
| Database: |
BASE |