Introduction
Pre-eclampsia/eclampsia, a hypertensive disorder of pregnancy, is a
serious and common obstetric
complication1. The
incidence of pre-eclampsia/eclampsia in pregnant women is 5-8%
worldwide, and it is a major cause of maternal morbidity and
mortality2-4.
Pre-eclampsia/eclampsia is defined as hypertension with high levels of
protein in their urine (i.e. proteinuria) after 20 weeks of gestation.
Severe pre-eclampsia/eclampsia is a serious threat to the lives of
mothers and fetuses, leading to cardiovascular and metabolic
complications for mothers and persistent bradycardia, hypotension, and
neonatal hypoglycemia for
fetuses5-7.
Pre-eclampsia/eclampsia may lead to serious kidney, brain, and blood
clotting problems which cause 10-15% of maternal deaths in lower-income
countries8,9.
Among these different sequelae of pre-eclampsia/eclampsia, stroke is a
serious one. The incidence of
stroke10-13, both
ischemic and hemorrhagic
subtypes14,15,
increased in the peripartum and postpartum stages. Stroke is an
important issue not only in the elderly, but also in pregnant women.
Stroke incidence ranges from 1.5 to 34.2 per 100,000 deliveries in
pregnancy and the
puerperium16,17.
It has been reported that pre-eclampsia/eclampsia-related stroke would
cause direct obstetric
death18,19.
The incidence of stroke in pregnant women in previous studies is varied
according to different preexisting risk
factors16,20.
It has been reported that the probability of
cardiovascular7 and
cerebrovascular
disease10,21in the next few years after childbirth in women with ever
pre-eclampsia/eclampsia would to be higher than that in the general
population. However, long-term impact of pre-eclampsia/eclampsia on
cerebrovascular disease is unknown.
In this study, we aimed to utilize a nationwide database to explore the
long-term overall, ischemic, and hemorrhagic stroke risks in women with
a history of pre-eclampsia/eclampsia, after decades follow up.