Abstract Details

Title Outcomes of Hospitalizations related to Child Birth in Women with Unruptured Intracranial Aneurysms

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S37 - Stroke Epidemiology: Risk Factors, Incidence, and Unique Populations (2:24 PM-2:36 PM)

Poster/Presentation
Number 008

Objective To determine the effect of unruptured aneurysms on maternal outcomes at the time of hospitalization for childbirth.

Background The incidence of subarachnoid hemorrhage (SAH) due to rupture of intracranial aneurysms is between 1 to 10 per 100,000 pregnancies, which is similar to the general population risk in the United States. The natural history of unruptured intracranial aneurysms during pregnancy, and the role of the aneurysm related risk factors in the pregnant patient with a UICA are poorly understood.

Design/Methods We used the Nationwide Inpatient Sample database (year 1998-2014) to identify all the
hospitalizations for childbirth and subsequently separated the patients with known history of UICA. The cohort of pregnant women with a known history of UICA was compared with the cohort of those without a known history of UICA. A propensity score matching was performed to reduce selection bias and the effects of confounding.

Results We identified a total of 13,670,171 hospitalizations for child birth, out of which 323 had a
known history of UICA. Patients with a known history of UICA had higher rates of intracranial
hemorrhage when compared to patients with no known history of UICA (Unmatched: 0.3-3% Vs
0.001%, p<0.0001; Matched 0.3-3% Vs 0%). We noted a higher incidence of essential hypertension
(6.89% vs. 1.1%, p<0.0001), preeclampsia (7.08% vs. 3.47%, p<0.0001), eclampsia (0.3-3% vs.
0.08%, p<0.0001), and smoking (8.21% vs. 3.96%, p<0.0001) at the time of delivery in patients with a known history of UICA. The incidence of Cesarean section was significantly higher in patients
with a known history of UICA (Unmatched: 78.64 Vs 29.55 %, p <0.0001; Matched 79.93 Vs. 41.28,
p <0.0001).

Conclusions Pregnant women with unruptured aneurysms may be at higher risk of baseline comorbidities, pregnancy related complications and intracranial hemorrhages. It may be prudent to consider preventive treatment for aneurysms with high risk features in pregnancy.

Authors/Disclosures
Tapan Mehta, MD (University of Connecticut, Hartford Hospital) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Shailesh Male, MD	Dr. Male has nothing to disclose.
Louise D. McCullough, MD, PhD (McGovern Medical School, UTHealth)	The institution of Dr. McCullough has received research support from NIH. The institution of Dr. McCullough has received research support from American Heart Association.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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