title: Preeclampsia-eclampsia and the risk of stroke among peripartum in Taiwan.
abstract: OBJECTIVE
  The occurrence of preeclampsia-eclampsia during pregnancy has been reported to increase the risk of stroke in mainly Western populations. However, few studies have evaluated stroke risk in Asian populations and followed women beyond the early postpartum period. Thus, the present study determined the risk of stroke in women in Taiwan during pregnancy and the first postpartum year.
  
  
  METHODS
  A population-based cohort study was performed on 1,132,019 parturients during 1999 to 2003 using a dataset linking birth certificates and National Health Insurance hospital discharge data. Stroke-free survival rates were estimated using the Kaplan-Meier method, and the log-rank test was used to examine the effect of preelampsia-eclampsia on the prevalence of stroke. Sociodemographic factors and obstetric complications were used in multivariate logistic regression models to determine the adjusted odds ratios of preeclampsia-eclampsia on the risk of hemorrhagic and ischemic stroke during pregnancy and within the first postpartum year.
  
  
  RESULTS
  The incidence of stroke was 21.47 cases per 100,000 deliveries. There were 139 cases of hemorrhagic stroke and 107 cases of ischemic stroke. The respective adjusted relative risk of preeclampsia-eclampsia for hemorrhagic and ischemic stroke were 10.68 (95% CI, 3.40 to 33.59) and 40.86 (95% CI, 12.14 to 137.47) within 3 months antepartum; 6.45 (95% CI, 1.42 to 29.29) and 34.71 (95% CI, 11.08 to 108.68) in the first 3 days postpartum; 5.61 (95% CI, 0.71 to 44.10) and 11.23 (95% CI, 2.45 to 51.59) from 3 days to 6 weeks postpartum; 11.76 (95% CI, 4.05 to 34.11) and 11.60 (95% CI, 3.30 to 40.82) from 6 weeks to 6 months pospartum; and 19.90 (95% CI, 7.75 to 51.11) and 4.35 (95% CI, 0.58 to 32.92) from 6 months to 12 months postpartum.
  
  
  CONCLUSIONS
  Women with preeclampsia-eclampsia have a significantly higher risk of stroke during pregnancy and in the first postpartum year. These results suggest that women with preeclampsia-eclampsia should be closely monitored even after pregnancy.
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.forename: Chuan-Song
authors.initials: CS
authors.lastname: Wu
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Sheng-Tzu
authors.initials: ST
authors.lastname: Hung
authors.forename: Chen-Yuan Charlie
authors.initials: CY
authors.lastname: Yang
authors.forename: Cheng-Hua
authors.initials: CH
authors.lastname: Lee
authors.forename: Pao-Hsien
authors.initials: PH
authors.lastname: Chu
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data*; D002545:Brain Ischemia / Q000208:ethnology / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000208:ethnology / Q000401:mortality; D004461:Eclampsia / Q000208:ethnology / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000208:ethnology / Q000401:mortality*; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology