{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:46:29Z","timestamp":1789778789428,"version":"4.0.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pregnancy-associated stroke carries high short-term morbidity and mortality, but data on subsequent maternal outcomes are limited. We evaluated long-term maternal health outcomes after pregnancy-associated stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this retrospective cohort study, we used administrative data to identify pregnant adults aged \u226449 years with stroke between 2002-2020 in Ontario, Canada and 2 comparison groups: (1) non-pregnant female patients with stroke and (2) pregnant patients without stroke. Patients who survived the index admission were followed until 2021. After propensity score matching, we used Cox regression with a robust variance estimator to compare pregnant patients with stroke and the 2 comparison groups for the composite outcome of death and all-cause non-pregnancy readmission. Where proportional hazard assumption was not met, we reported time-varying hazard ratios (HR) with 95% CIs by modeling the log-hazard ratio as a function of time using restricted cubic splines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 217 pregnant patients with stroke, 7604 non-pregnant patients with stroke, and 1\u2009496\u2009256 pregnant patients without stroke. Of the 202 pregnant patients with stroke who survived the index stroke admission, 41.6% (6.8 per 100 person-years) subsequently died or were readmitted during follow-up. Median follow-up times were 5 years (pregnancy-associated stroke), 3 years (non-pregnant stroke), and 8 years (pregnant without stroke). Pregnant patients with stroke had a lower hazard of death and all-cause readmission compared with non-pregnant patients with stroke at 1-year follow-up (HR, 0.64 [95% CI, 0.44\u20130.94]), but this association did not persist during longer-term follow-up. Conversely, pregnant patients with stroke had higher hazard of death and readmission compared with pregnant patients without stroke at 1-year follow-up (HR, 5.70 [95% CI, 3.04\u201310.66]), and this association persisted for a decade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Stroke during pregnancy is associated with long-term health consequences. It is essential to transition care postpartum to primary or specialty care to optimize vascular health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.122.041471","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T14:00:59Z","timestamp":1674482459000},"page":"337-344","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Maternal Health Outcomes After Pregnancy-Associated Stroke: A Population-Based Study With 19 Years of Follow-Up"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-9551","authenticated-orcid":true,"given":"Amy Y.X.","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, Ontario, Canada (A.Y.X.Y.)."},{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara A.","family":"Nerenberg","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Obstetrics and Gynecology, University of Calgary, Alberta, Canada (K.A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Diong","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-0987","authenticated-orcid":true,"given":"Jiming","family":"Fang","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4614-7684","authenticated-orcid":true,"given":"Anna","family":"Chu","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3444-9928","authenticated-orcid":true,"given":"Moira K.","family":"Kapral","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."},{"name":"Department of Medicine (General Internal Medicine), University of Toronto-University Health Network, Ontario, Canada (M.K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-4787","authenticated-orcid":true,"given":"Jodi D.","family":"Edwards","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."},{"name":"University of Ottawa Heart Institute, Ontario, Canada (J.D.E., S.R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-2899","authenticated-orcid":true,"given":"Sonia R.","family":"Dancey","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute, Ontario, Canada (J.D.E., S.R.D.)."},{"name":"School of Epidemiology and Public Heath, University of Ottawa, Ontario, Canada (J.D.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3337-233X","authenticated-orcid":true,"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada (A.Y.X.Y., C.D., J.F., A.C., M.K.K., J.D.E., P.C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-0459","authenticated-orcid":true,"given":"Nathalie","family":"Auger","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Quebec, Canada (N.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017723271"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.118.023118"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.016"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051460"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2339-y"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2217\/whe.11.19"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.4571"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000449288"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2016.278"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2021.235"},{"key":"e_1_3_3_12_2","unstructured":"Canadian Institute for Health Information. 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