Pregnancy Safe for Women with Prior cervical Artery Dissection, Study Finds
New research offers reassuring news for women with a history of cervical artery dissection (CeAD), indicating that pregnancy does not elevate the risk of recurrent cead, stroke, or death.
Basel, Switzerland – For women who have experienced cervical artery dissection (CeAD), the prospect of future pregnancy may no longer be a cause for significant concern. A groundbreaking cohort study, published in JAMA Network Open, reveals that pregnancy is not associated with an increased risk of recurrent CeAD, stroke, or death up to five years later.
The study, led by Sandro K. Fischer of the University Hospital Basel, analyzed data from 1013 women with a history of CeAD across 33 stroke centers in nine countries, with follow-up data extending from 1990 to 2023. Of these women, 114 became pregnant during the study period, while 899 did not.
Researchers tracked a composite outcome of recurrent CeAD, any type of stroke, and all-cause mortality. The findings demonstrated that the composite outcome occurred in 9% of the pregnancy group, compared to 7% in the non-pregnancy group. Crucially, the adjusted hazard ratio (aHR) for this composite outcome was 0.77 (95% CI, 0.38-1.56), indicating no statistically significant increase in risk for pregnant women.
Further analysis of secondary outcomes also showed no significant differences between the groups for recurrent CeAD (aHR,1.0), ischemic stroke (aHR, 0.5), and intracerebral hemorrhage (ICH) (aHR, 1.0). The incidence rate of recurrent CeAD was 0.7% per patient-year in the pregnancy group versus 0.5% per patient-year in the non-pregnancy group.
Interestingly, five of the ten primary outcome events in the pregnancy group occurred during the postpartum period, suggesting a potential heightened vulnerability during this specific phase.
“These findings suggest that pregnancy is not associated with an increased risk of subsequent events; therefore, prior CeAD does not justify advising against future pregnancy,” the investigators stated. They added that these results “may be helpful for individual counseling and family planning for women with prior CeAD.”
While the study offers significant reassurance,its exploratory nature,potential referral bias,and the underrepresentation of women at higher presumed recurrence risk in the pregnancy group are noted limitations. The small number of events also contributed to statistical imprecision.
Despite these limitations, the study’s findings provide valuable insights for clinicians and patients, potentially alleviating anxieties surrounding pregnancy for women with a history of CeAD and supporting informed family planning decisions.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.