{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T08:11:17Z","timestamp":1793434277455,"version":"4.5.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Intracerebral hemorrhage (ICH) is a major cause of maternal morbidity, but its pathophysiology is poorly characterized. We investigated characteristics of pregnancy\u2010associated ICH (P\u2010ICH), compared with ICH in similar aged nonpregnant adults of both sexes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a retrospective analysis of 134 adults aged 18 to 44\u2009years admitted to our center with nontraumatic ICH from January 1, 2012, to December 31, 2021. We compared ICH characteristics among 3 groups: those with P\u2010ICH (pregnant or within 12\u2009months of end of pregnancy); nonpregnant women; and men. We categorized ICH pathogenesis according to a modified scheme, SMASH\u2010UP (structural, medications, amyloid angiopathy, systemic, hypertension, undetermined, posterior reversible encephalopathy syndrome\/reversible cerebral vasoconstriction syndrome), and calculated odds ratios and 95% CIs for primary (spontaneous small\u2010vessel) ICH versus secondary ICH (structural lesions or coagulopathy related), using nonpregnant women as the reference. We also compared specific ICH pathogenesis by SMASH\u2010UP criteria and functional outcomes between groups. Of 134 young adults with nontraumatic ICH, 25 (19%) had P\u2010ICH, of which 60% occurred postpartum. Those with P\u2010ICH had higher odds of primary ICH compared with nonpregnant women (adjusted odds ratio, 4.5 [95% CI, 1.4\u201314.7]). The odds of primary ICH did not differ between men and nonpregnant women. SMASH\u2010UP pathogenesis for ICH differed significantly between groups (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). While the in\u2010hospital mortality rate was lowest in the P\u2010ICH group (4%) compared with nonpregnant women (13%) and men (24%), 1 in 4 patients with P\u2010ICH were bedbound and dependent at the time of discharge.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In our cohort of young adults with ICH, 1 in 5 was pregnancy related. P\u2010ICH differed in pathogenesis compared with non\u2013pregnancy\u2010related ICH in young adults, suggesting unique pathophysiology.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.034032","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T11:59:40Z","timestamp":1711540780000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Primary and Secondary Intracerebral Hemorrhage in Pregnant and Nonpregnant Young Adults by SMASH\u2010UP Criteria"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4799-4551","authenticated-orcid":false,"given":"Mehriban","family":"Sariyeva","sequence":"first","affiliation":[{"name":"Department of Neurology, Stroke Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noora","family":"Haghighi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-069X","authenticated-orcid":false,"given":"Whitney A.","family":"Booker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal\u2010Fetal Medicine Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9711-3340","authenticated-orcid":false,"given":"Nils H.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Yale University New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea D.","family":"Shields","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal\u2010Fetal Medicine Division University of Connecticut Health Hartford CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Ghoshal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3688-7307","authenticated-orcid":false,"given":"Soojin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Columbia University New York NY"},{"name":"Department of Biomedical Informatics Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Claassen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurocritical Care Division Columbia University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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