Increased mortality risk from pregnancy-related stroke in black women

Hospital mortality from pregnancy-associated stroke (PAS) was increased in black women, according to study results presented remotely at the International Stroke Conference March 17-19, 2021.

Study researchers at the Cleveland Clinic analyzed data collected between 2002 and 2017 in the United States using the Nationwide Inpatient Sample. Pregnant and postpartum women (N = 38,797,752), for example, were examined for PAS and the associated mortality based on race.

Within the study cohort, 21.9% were black and 0.03% (n = 10,959) had PAS.

Despite the fact that black women made up about a fifth of the total cohort, more than a third of women who had a PAS event (41.3%; n = 4521) were black. Stratified by race, the in-hospital mortality rates from PAS were 7.8% for black women and 5.0% for white women (P <0.001).

Stratified by age and race, black women between 18 and 24 years of age had an increased mortality rate compared to white women of the same age (adjusted odds ratio) [aOR]2.10; 95% Cl, 1.88-2.35; P <0.001). The mortality risk increased in people aged 25 to 29 years (aOR 2.75; 95% CI 2.46-3.07; P <0.001) and 30 to 34 years (aOR 3.94; 95% CI 3.50 -4.43); P <0.001). Between the ages of 35 and 40, the risk of hospital PAS mortality began to decrease in black women (aOR 3.73; 95% CI 3.25-4.29; P <0.001). The risk was lowest among black women older than 40 years (aOR 1.27; 95% CI 1.08-1.51; P = 0.005).

Socio-economic status appeared to be a major contributor to mortality among black women. Black women in the quartile with the lowest income had a lower risk than their white counterparts (aOR 1.91; 95% CI 1.74-2.10) than women in the highest quartile (aOR 2.38; 95% CI 2 , 02-2.80).

These results indicated an increased risk of PAS and associated hospital mortality in black women compared to white women. Age and socio-economic characteristics contributed to the patterns observed. Study researchers added: “[t]Targeted interventions are required to minimize these observed racial differences. ”


Gad MM, Abdeldayem J, Abdelfattah OM, Saad AM, Mahmoud AM, Elgendy IY. Racial Differences in Pregnancy-Associated Stroke, a US Nationwide Cohort Study. Presented at: International Stroke Conference; 17th-19th March 2021. Presentation P869.

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