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Delivery infections contribute to increased postpartum ischaemic stroke risk

10 Sep 2019

Women who develop infection during delivery hospitalization are at higher risk of being readmitted for ischaemic stroke (IS) within 30 days postpartum, especially those with no hypertensive disorders of pregnancy, a study reports.

Researchers drew data from the Healthcare Cost and Utilization Project’s National Readmissions Database from 2010 to 2014. They looked at 17.2 million delivery admissions during the study period and identified 2,128 women readmitted within 30 days (median time to readmission, 6.7 days) for a stroke of any type. Of these women, 1,189 had haemorrhagic stroke (HS; intracerebral haemorrhage or subarachnoid haemorrhage), 720 had IS, and the remainder had unspecified pregnancy-related stroke.

During the initial delivery hospitalization, ≥1 infections developed in 876,633 women (5.1 percent) who did not go on to have a postpartum stroke and in 154 (7.3 percent) of the 2,128 women who were readmitted within 30 days for stroke.

On multivariate Poisson regression analysis, women with delivery infections were at higher risk of readmission for postpartum stroke of any type (adjusted risk ratio [aRR], 1.19, 95 percent CI, 1.01–1.41) and postpartum IS (aRR, 1.75, 1.37–2.22) but not for postpartum HS (aRR, 0.96, 0.75–1.23).

The effect of infection on 30-day postpartum IS readmission was more pronounced in women without hypertensive disorders of pregnancy than in those who had them (aRR, 2.0, 1.55–2.69 vs 1.47, 0.9–2.38; p-interaction=0.09).

According to the researchers, infection may play a role in triggering postpartum IS even in the absence of other risk factors. As such, women with infections during delivery admissions should be counselled on signs and symptoms of stroke and should submit to closer postpartum follow-up.

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Most Read Articles
01 Dec 2019
Macrolide antibiotics are derived from the Streptomycesspecies. These contain either 14-membered (erythromycin [ERM],clarithromycin [CAM], roxithromycin [RXM]), 15-membered(azithromycin [AZM]) or 16-membered (spiramycin, josamycin,midecamycin) macrocyclic lactone rings. They inhibit proteinsynthesis by reversibly binding to the 23S ribosomal RNA (rRNA)in the 50s subunit of the bacterial ribosome. Traditionally,macrolides are used as first-line agents in respiratory, skin,soft tissue, and urogenital infections, and they are also activeagainst gram-positive cocci and atypical pathogens.
19 Jun 2019
Acquired immunodeficiency syndrome (AIDS) remains as one of the world’s leading causes of mortality in global public health. Dr Charles Hicks shared his insights into the increasing role of dolutegravir (DTG; Tivicay, GSK) – an integrase strand transfer inhibitor (INSTI) – in HIV therapy during the 4th National AIDS Conference 2018 at Swiss Garden International Hotel and Residences, Kuala Lumpur.
21 Sep 2019
Cryptococcosis is more common in nonhuman immunodeficiency virus (HIV) nontransplant (NHNT) patients, and this population tends to have more localized pulmonary cryptococcosis and significantly higher 90-day mortality, reports a study.
Stephen Padilla, 07 May 2019
The risk of HIV transmission is “effectively zero” among gay couples who have condomless anal sex when the HIV viral load is suppressed, according to a new study.