Abstract WMP80: 20 Year Incidence and Outcomes for Intracerebral Hemorrhage During Pregnancy: A Nationwide Study

Introduction: Pregnant patients are at risk of neurological complications including intracerebral hemorrhage (ICH). We aim to further characterize this risk and its in hospital consequences using a large population based sample over a 20 year study period.

Methods: Using the Nationwide Inpatient Sample (2000-2019), we selected for patients who had ICH. We compared characteristics between pregnant and non-pregnant patients using t-tests and chi-squared tests. A 1:1 propensity score matched cohort was generated. Variables with standardized mean differences >0.1 were used in multivariable regression to generate adjusted odds ratios (AOR)/beta coefficients to determine the impact of pregnancy on outcomes.

Results: In our study involving 2,000,675 ICH patients, 5,107 were pregnant (0.26%). We observed an increasing trend of ICH among pregnant individuals. Pregnant patients were notably younger (30.63 vs 63.38, p<0.001) and had fewer comorbidities such as cancer and chronic kidney disease, atrial fibrillation, hypertension, hyperlipidemia. Interestingly, a greater percentage of pregnant ICH patients African American (25.0% vs 16.2%, p<0.001). Pregnant patients experienced lower in-hospital mortality (12.4% vs 24.7%, p<0.001) and were more frequently discharged home or to short-term hospital (53.8% vs 23.2%, p<0.001). After propensity matching, pregnant patients shower lower odds of in-hospital mortality (AOR 0.68, p=0.008), but other outcomes including discharge outcomes and hospital charges remained similar.

Conclusion: ICH is a rare complication in pregnancy, occurring in 0.26% of cases, and presenting roughly a 14% risk of in-hospital mortality. However, patients they appear to have lower rates of mortality than the overall ICH population. There may be a racial disparity in pregnancy related ICH as well, with African American experiencing this complication at a higher rate than other races.