Patients undergoing infertility treatment may have levated risk of stroke

The researchers highlighted the need for further investigation into this relationship and that efforts should be directed towards eliminating all factors associated with an increased risk of stroke and other cardiovascular events during the antenatal and postpartum periods.

The American College of Obstetricians and Gynecologists recommends routine follow-up within three weeks of delivery, with an additional follow-up within 12 weeks. Higher-risk patients, such as those with hypertensive disorders of pregnancy, are advised to have follow-ups between seven and ten days postpartum.

Given the association between infertility treatment and an increased risk of hemorrhagic and ischemic strokes, perhaps we should consider early and ongoing follow-up for patients undergoing infertility treatment.

The lead researcher of this original investigation, “Risk of Stroke Hospitalization After Infertility Treatment,” is Dr. Devika Sachdev et al.

In this study of 31,339,991 pregnant individuals who delivered between 2010 and 2018, those who received infertility treatment had a higher risk of stroke hospitalization within 12 months of delivery. Specifically, the risk of hospitalization for hemorrhagic stroke was significantly greater than that for ischemic stroke.

This study is a retrospective cohort study that used data from the Nationwide Readmissions Database. The data was collected from hospital inpatient stays from 28 states in the US between 2010 and 2018.

The primary objective was to determine the occurrence of hospitalization for nonfatal stroke (either ischemic or hemorrhagic stroke) within the first year after childbirth. The study also focused on the risk of stroke hospitalization at less than 30 days, less than 60 days, less than 90 days, and less than 180 days postpartum. Cox proportional hazard regression models were used to quantify the associations, and hazard ratios (HRs) were reported, which were adjusted for confounders.

The key results of the study are:

• Two hundred eighty-seven thousand eight hundred thirteen underwent infertility treatment, and 31 052 178 patients aged 27.7 years delivered after spontaneous conception.
• The stroke hospitalisation rate was 37 hospitalizations per 100,000 people who received infertility treatment and 29 hospitalizations per 100,000 people among those who delivered after spontaneous conception.
• The rate difference was eight hospitalizations per 100,000 people.
• The risk of stroke hospitalization increased as the time between delivery and hospitalization for stroke increased, particularly for hemorrhagic strokes.
• These associations became larger for hemorrhagic stroke and smaller for ischemic stroke following correction for biases.

The study implies that undergoing infertility treatment may increase the likelihood of being hospitalized for a stroke within 12 months of giving birth. Therefore, conducting thorough screening for potential risks and providing timely follow-up care is crucial to minimize the likelihood of stroke during the antepartum and postpartum periods.

Further reading:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808926