Intracerebral hemorrhage in pregnancy

Frequency, risk factors, and outcome

B. T. Bateman, H. C. Schumacher, C. D. Bushnell, J. Pile-Spellman, L. L. Simpson, Ralph L Sacco, M. F. Berman

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

OBJECTIVE: To describe the frequency, risk factors, and outcome of intracerebral hemorrhage (ICH) in pregnancy and the postpartum period using a large database of US inpatient hospitalizations. METHODS: The authors obtained data from an administrative dataset, the Nationwide Inpatient Sample, which includes approximately 20% of all discharges from non-Federal hospitals, for the years 1993 through 2002. Women aged 15 to 44 years with a diagnosis of ICH were selected from the database for analysis, and within this group patients coded as pregnant or postpartum were identified. Using US Census data, estimates were made of the rates of ICH in pregnant/postpartum and non-pregnant women. Rates of various comorbidities in patients with pregnancy-related ICH were compared to the rates found in the general population of delivering patients using multivariate logistic regression to identify independent risk factors for pregnancy-related ICH. RESULTS: The authors identified 423 patients with pregnancy-related ICH, which corresponded to 6.1 pregnancy-related ICH per 100,000 deliveries and 7.1 pregnancy-related ICH per 100,000 at-risk person-years (compared to 5.0 per 100,000 person-years for non-pregnant women in the age range considered). The increased risk of ICH associated with pregnancy was largely attributable to ICH occurring in the postpartum period. The in-hospital mortality rate for pregnancy-related ICH was 20.3%. ICH accounted for 7.1% of all pregnancy-related mortality recorded in this database. Significant independent risk factors for pregnancy-related ICH included advanced maternal age (OR 2.11, 95% CI 1.69 to 2.64), African American race (OR 1.83, 95% CI 1.39 to 2.41), preexisting hypertension (OR 2.61, 95% CI 1.34 to 5.07), gestational hypertension (OR 2.41, 95% CI 1.62 to 3.59), preeclampsia/eclampsia (OR 10.39, 95% CI 8.32 to 12.98), preexisting hypertension with superimposed preeclampsia/eclampsia (OR 9.23, 95% CI 5.26 to 16.19), coagulopathy (OR 20.66, 95% CI 13.67 to 31.23), and tobacco abuse (OR 1.95, 95% CI 1.11 to 3.42). CONCLUSION: Intracerebral hemorrhage (ICH) accounts for a substantial portion of pregnancy-related mortality. The risk of ICH associated with pregnancy is greatest in the postpartum period. Advanced maternal age, African American race, hypertensive diseases, coagulopathy, and tobacco abuse were all independent risk factors for pregnancy-related ICH.

Original languageEnglish
Pages (from-to)424-429
Number of pages6
JournalNeurology
Volume67
Issue number3
DOIs
StatePublished - Aug 1 2006
Externally publishedYes

Fingerprint

Cerebral Hemorrhage
Pregnancy
Postpartum Period
Eclampsia
Maternal Age
Databases
Pre-Eclampsia
African Americans
Tobacco
Mortality
Inpatients
Hypertension
Pregnancy Induced Hypertension
Censuses
Hospital Mortality

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Bateman, B. T., Schumacher, H. C., Bushnell, C. D., Pile-Spellman, J., Simpson, L. L., Sacco, R. L., & Berman, M. F. (2006). Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome. Neurology, 67(3), 424-429. https://doi.org/10.1212/01.wnl.0000228277.84760.a2

Intracerebral hemorrhage in pregnancy : Frequency, risk factors, and outcome. / Bateman, B. T.; Schumacher, H. C.; Bushnell, C. D.; Pile-Spellman, J.; Simpson, L. L.; Sacco, Ralph L; Berman, M. F.

In: Neurology, Vol. 67, No. 3, 01.08.2006, p. 424-429.

Research output: Contribution to journalArticle

Bateman, BT, Schumacher, HC, Bushnell, CD, Pile-Spellman, J, Simpson, LL, Sacco, RL & Berman, MF 2006, 'Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome', Neurology, vol. 67, no. 3, pp. 424-429. https://doi.org/10.1212/01.wnl.0000228277.84760.a2
Bateman BT, Schumacher HC, Bushnell CD, Pile-Spellman J, Simpson LL, Sacco RL et al. Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome. Neurology. 2006 Aug 1;67(3):424-429. https://doi.org/10.1212/01.wnl.0000228277.84760.a2
Bateman, B. T. ; Schumacher, H. C. ; Bushnell, C. D. ; Pile-Spellman, J. ; Simpson, L. L. ; Sacco, Ralph L ; Berman, M. F. / Intracerebral hemorrhage in pregnancy : Frequency, risk factors, and outcome. In: Neurology. 2006 ; Vol. 67, No. 3. pp. 424-429.
@article{0547187f7a0f42358e0a8d45ec86dc83,
title = "Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome",
abstract = "OBJECTIVE: To describe the frequency, risk factors, and outcome of intracerebral hemorrhage (ICH) in pregnancy and the postpartum period using a large database of US inpatient hospitalizations. METHODS: The authors obtained data from an administrative dataset, the Nationwide Inpatient Sample, which includes approximately 20{\%} of all discharges from non-Federal hospitals, for the years 1993 through 2002. Women aged 15 to 44 years with a diagnosis of ICH were selected from the database for analysis, and within this group patients coded as pregnant or postpartum were identified. Using US Census data, estimates were made of the rates of ICH in pregnant/postpartum and non-pregnant women. Rates of various comorbidities in patients with pregnancy-related ICH were compared to the rates found in the general population of delivering patients using multivariate logistic regression to identify independent risk factors for pregnancy-related ICH. RESULTS: The authors identified 423 patients with pregnancy-related ICH, which corresponded to 6.1 pregnancy-related ICH per 100,000 deliveries and 7.1 pregnancy-related ICH per 100,000 at-risk person-years (compared to 5.0 per 100,000 person-years for non-pregnant women in the age range considered). The increased risk of ICH associated with pregnancy was largely attributable to ICH occurring in the postpartum period. The in-hospital mortality rate for pregnancy-related ICH was 20.3{\%}. ICH accounted for 7.1{\%} of all pregnancy-related mortality recorded in this database. Significant independent risk factors for pregnancy-related ICH included advanced maternal age (OR 2.11, 95{\%} CI 1.69 to 2.64), African American race (OR 1.83, 95{\%} CI 1.39 to 2.41), preexisting hypertension (OR 2.61, 95{\%} CI 1.34 to 5.07), gestational hypertension (OR 2.41, 95{\%} CI 1.62 to 3.59), preeclampsia/eclampsia (OR 10.39, 95{\%} CI 8.32 to 12.98), preexisting hypertension with superimposed preeclampsia/eclampsia (OR 9.23, 95{\%} CI 5.26 to 16.19), coagulopathy (OR 20.66, 95{\%} CI 13.67 to 31.23), and tobacco abuse (OR 1.95, 95{\%} CI 1.11 to 3.42). CONCLUSION: Intracerebral hemorrhage (ICH) accounts for a substantial portion of pregnancy-related mortality. The risk of ICH associated with pregnancy is greatest in the postpartum period. Advanced maternal age, African American race, hypertensive diseases, coagulopathy, and tobacco abuse were all independent risk factors for pregnancy-related ICH.",
author = "Bateman, {B. T.} and Schumacher, {H. C.} and Bushnell, {C. D.} and J. Pile-Spellman and Simpson, {L. L.} and Sacco, {Ralph L} and Berman, {M. F.}",
year = "2006",
month = "8",
day = "1",
doi = "10.1212/01.wnl.0000228277.84760.a2",
language = "English",
volume = "67",
pages = "424--429",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Intracerebral hemorrhage in pregnancy

T2 - Frequency, risk factors, and outcome

AU - Bateman, B. T.

AU - Schumacher, H. C.

AU - Bushnell, C. D.

AU - Pile-Spellman, J.

AU - Simpson, L. L.

AU - Sacco, Ralph L

AU - Berman, M. F.

PY - 2006/8/1

Y1 - 2006/8/1

N2 - OBJECTIVE: To describe the frequency, risk factors, and outcome of intracerebral hemorrhage (ICH) in pregnancy and the postpartum period using a large database of US inpatient hospitalizations. METHODS: The authors obtained data from an administrative dataset, the Nationwide Inpatient Sample, which includes approximately 20% of all discharges from non-Federal hospitals, for the years 1993 through 2002. Women aged 15 to 44 years with a diagnosis of ICH were selected from the database for analysis, and within this group patients coded as pregnant or postpartum were identified. Using US Census data, estimates were made of the rates of ICH in pregnant/postpartum and non-pregnant women. Rates of various comorbidities in patients with pregnancy-related ICH were compared to the rates found in the general population of delivering patients using multivariate logistic regression to identify independent risk factors for pregnancy-related ICH. RESULTS: The authors identified 423 patients with pregnancy-related ICH, which corresponded to 6.1 pregnancy-related ICH per 100,000 deliveries and 7.1 pregnancy-related ICH per 100,000 at-risk person-years (compared to 5.0 per 100,000 person-years for non-pregnant women in the age range considered). The increased risk of ICH associated with pregnancy was largely attributable to ICH occurring in the postpartum period. The in-hospital mortality rate for pregnancy-related ICH was 20.3%. ICH accounted for 7.1% of all pregnancy-related mortality recorded in this database. Significant independent risk factors for pregnancy-related ICH included advanced maternal age (OR 2.11, 95% CI 1.69 to 2.64), African American race (OR 1.83, 95% CI 1.39 to 2.41), preexisting hypertension (OR 2.61, 95% CI 1.34 to 5.07), gestational hypertension (OR 2.41, 95% CI 1.62 to 3.59), preeclampsia/eclampsia (OR 10.39, 95% CI 8.32 to 12.98), preexisting hypertension with superimposed preeclampsia/eclampsia (OR 9.23, 95% CI 5.26 to 16.19), coagulopathy (OR 20.66, 95% CI 13.67 to 31.23), and tobacco abuse (OR 1.95, 95% CI 1.11 to 3.42). CONCLUSION: Intracerebral hemorrhage (ICH) accounts for a substantial portion of pregnancy-related mortality. The risk of ICH associated with pregnancy is greatest in the postpartum period. Advanced maternal age, African American race, hypertensive diseases, coagulopathy, and tobacco abuse were all independent risk factors for pregnancy-related ICH.

AB - OBJECTIVE: To describe the frequency, risk factors, and outcome of intracerebral hemorrhage (ICH) in pregnancy and the postpartum period using a large database of US inpatient hospitalizations. METHODS: The authors obtained data from an administrative dataset, the Nationwide Inpatient Sample, which includes approximately 20% of all discharges from non-Federal hospitals, for the years 1993 through 2002. Women aged 15 to 44 years with a diagnosis of ICH were selected from the database for analysis, and within this group patients coded as pregnant or postpartum were identified. Using US Census data, estimates were made of the rates of ICH in pregnant/postpartum and non-pregnant women. Rates of various comorbidities in patients with pregnancy-related ICH were compared to the rates found in the general population of delivering patients using multivariate logistic regression to identify independent risk factors for pregnancy-related ICH. RESULTS: The authors identified 423 patients with pregnancy-related ICH, which corresponded to 6.1 pregnancy-related ICH per 100,000 deliveries and 7.1 pregnancy-related ICH per 100,000 at-risk person-years (compared to 5.0 per 100,000 person-years for non-pregnant women in the age range considered). The increased risk of ICH associated with pregnancy was largely attributable to ICH occurring in the postpartum period. The in-hospital mortality rate for pregnancy-related ICH was 20.3%. ICH accounted for 7.1% of all pregnancy-related mortality recorded in this database. Significant independent risk factors for pregnancy-related ICH included advanced maternal age (OR 2.11, 95% CI 1.69 to 2.64), African American race (OR 1.83, 95% CI 1.39 to 2.41), preexisting hypertension (OR 2.61, 95% CI 1.34 to 5.07), gestational hypertension (OR 2.41, 95% CI 1.62 to 3.59), preeclampsia/eclampsia (OR 10.39, 95% CI 8.32 to 12.98), preexisting hypertension with superimposed preeclampsia/eclampsia (OR 9.23, 95% CI 5.26 to 16.19), coagulopathy (OR 20.66, 95% CI 13.67 to 31.23), and tobacco abuse (OR 1.95, 95% CI 1.11 to 3.42). CONCLUSION: Intracerebral hemorrhage (ICH) accounts for a substantial portion of pregnancy-related mortality. The risk of ICH associated with pregnancy is greatest in the postpartum period. Advanced maternal age, African American race, hypertensive diseases, coagulopathy, and tobacco abuse were all independent risk factors for pregnancy-related ICH.

UR - http://www.scopus.com/inward/record.url?scp=33747032288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33747032288&partnerID=8YFLogxK

U2 - 10.1212/01.wnl.0000228277.84760.a2

DO - 10.1212/01.wnl.0000228277.84760.a2

M3 - Article

VL - 67

SP - 424

EP - 429

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 3

ER -