(904) Transient Ischemic Attack and Obstetric and Neonatal Outcomes - A Population-Based Study

We conducted a retrospective population-based cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Included in the study were all pregnant women who delivered or had a maternal death in the US between 2004-2014. We compared women with an ICD-9 diagnosis of TIA to those without. Pregnancy, delivery, and neonatal outcomes were compared between the two groups using multivariate logistic regression models adjusting for baseline maternal characteristics.

Results: A total of 9,096,788 women met the inclusion criteria. Amongst them, 203 women (2.2/100,000) had a diagnosis of TIA (either prior to or during pregnancy). Women with TIA, compared to those without, were more likely to be older than 35 years of age; Caucasian; in the highest income quartile; be insured by private insurance; and suffer from obesity and chronic hypertension (P< 0.001, all). Patients in the TIA group, compared to those without, had a higher rate of pregnancy-induced hypertension (aOR 2.5, 95% CI 1.55-4.05, p< 0.001), preeclampsia (aOR 3.77, 95% CI 2.15-6.62, p< 0.001, and eclampsia (aOR 28.05, 95% CI 6.91-113.95, p< 0.001). Additionally, they had a higher rate of preterm delivery (aOR 1.78, 95% CI 1.03-3.07, p=0.039) and maternal complications such as venous thromboembolism (aOR 22.66, 95% CI 5.49-93.48, p< 0.001). Regarding neonatal outcomes, patients with a TIA, compared to those without, had a higher rate of congenital anomalies (aOR 7.04, 95% CI 2.86-17.32, p< 0.001).

Conclusion: Women diagnosed with a TIA before or during pregnancy had a higher incidence of maternal complications, including hypertensive disorders of pregnancy and venous thromboembolism, as well as an increased risk of congenital anomalies.