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Population Based Birth Prevalence of Disease-Specific Perinatal Stroke
- Source :
- Pediatrics. 146(5)
- Publication Year :
- 2020
-
Abstract
- BACKGROUND: Perinatal stroke encompasses multiple disease-specific cerebrovascular syndromes that cause lifelong neurodevelopmental morbidity for millions worldwide. Acute presentations include neonatal arterial ischemic stroke (NAIS), neonatal cerebral sinovenous thrombosis, and neonatal hemorrhagic stroke (NHS). Delayed presentations include arterial presumed perinatal ischemic stroke, periventricular venous infarction, and presumed perinatal hemorrhagic stroke. Our objective was to define the birth prevalence of all subtypes of perinatal stroke by using a population-based cohort. METHODS: The Alberta Perinatal Stroke Project is a research cohort established in 2008 in southern Alberta, Canada, with prospective (2008–2017) and retrospective (1990–2008) enrollment leveraging universal health care at a single tertiary care pediatric center. The primary outcome was the estimated birth prevalence of each perinatal stroke syndrome, secondary outcomes were birth prevalence over time, sex ratios, and change in age at diagnosis. Analysis included Poisson regression, Wilcoxon rank test, and Fisher exact test. RESULTS: The overall estimated birth prevalence of term-born perinatal stroke was 1:1100. The estimated birth prevalence was 1:3000 for NAIS, 1:7900 for arterial presumed perinatal ischemic stroke, 1:6000 for periventricular venous infarction, 1:9100 for cerebral sinovenous thrombosis, 1:6800 for NHS, and 1:65000 for presumed perinatal hemorrhagic stroke. The apparent birth prevalence of NAIS and NHS increased over time. There were more males affected than females. The age at diagnosis decreased for late-presenting stroke types. CONCLUSIONS: The estimated birth prevalence of term perinatal stroke is higher than previous estimates, which may be explained by population-based sampling of disease-specific states. This emphasizes the need for further studies to better understand the disease-specific pathophysiology to improve treatment and prevention strategies.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Population
Statistics, Nonparametric
Alberta
Brain Ischemia
Cohort Studies
Tertiary Care Centers
03 medical and health sciences
symbols.namesake
0302 clinical medicine
030225 pediatrics
Prevalence
Medicine
Humans
cardiovascular diseases
Poisson regression
Poisson Distribution
Prospective Studies
Sex Distribution
education
Prospective cohort study
Stroke
Fisher's exact test
Cerebral Hemorrhage
Retrospective Studies
education.field_of_study
business.industry
Age Factors
Infant, Newborn
Retrospective cohort study
Cerebral Infarction
medicine.disease
Hospitals, Pediatric
Pediatrics, Perinatology and Child Health
Cohort
symbols
Female
Intracranial Thrombosis
business
Cohort study
Subjects
Details
- ISSN :
- 10984275
- Volume :
- 146
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....29923f7b9117cf5042efc0adc604df71