American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 391.e1-391.e7, April 2008

Increased risk of stroke in patients who undergo cesarean section delivery: a nationwide population-based study

  • Shiyng-Yu Lin, MD

      Affiliations

    • Department of Family Practice, Taipei Medical University, Taipei, Taiwan, Republic of China
    • Topnotch Stroke Research Center, Taipei Medical University, Taipei, Taiwan, Republic of China
    • School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
    • ,
  • Chaur-Jong Hu, MD

      Affiliations

    • Department of Neurology, Taipei Medical University, Taipei, Taiwan, Republic of China
    • Topnotch Stroke Research Center, Taipei Medical University, Taipei, Taiwan, Republic of China
    • School of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
    • ,
  • Herng-Ching Lin, PhD

      Affiliations

    • Topnotch Stroke Research Center, Taipei Medical University, Taipei, Taiwan, Republic of China
    • School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, Republic of China.
    • Corresponding Author InformationReprints: Herng-Ching Lin, School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St, Taipei 110, Taiwan.

Received 28 June 2007; accepted 11 October 2007. published online 15 February 2008.

Objective

This study used a population-based dataset to determine whether (compared with vaginal deliveries), cesarean section deliveries increase the risk of postpartum stroke during the 3-, 6-, or 12-month period after delivery.

Study Design

This study used 1998-2003 records from the Taiwan National Health Insurance Research Database for 987,010 women with singleton deliveries from 1998-2002. Cox proportional hazard regressions were carried out to compute stroke-free survival rates between the 2 delivery modes.

Results

The regression model indicated that, compared with patients who delivered vaginally, the hazard ratio for postpartum stroke among those who delivered by cesarean section was 1.67 times greater within 3 months of delivery (95% CI, 1.29-2.16), was 1.61 times greater within 6 months of delivery (95% CI, 1.31-1.98), and was 1.49 times greater within 12 months of delivery (95% CI, 1.27-1.76).

Conclusion

Our data indicates that cesarean section delivery is an independent risk factor for stroke.

Key words: cesarean section, postpartum stroke, stroke

 

 Cite this article as: Lin S-Y, Hu C-J, Lin H-C. Increased risk of stroke in patients who undergo cesarean section delivery: a nationwide population-based study. Am J Obstet Gynecol 2008;198:391.e1-391.e7.

 This study was sponsored by a grant from Topnotch Stroke Research Center, Ministry of Education, Taiwan.

 This study is based, in part, on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not necessarily represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes.

PII: S0002-9378(07)02011-X

doi:10.1016/j.ajog.2007.10.789

American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 391.e1-391.e7, April 2008