Aneurysmal subarachnoid hemorrhage in pregnancy: National trends of treatment, predictors, and outcomes

Authors

Kasra Khatibi, University of Southern California, Los Angeles, CA
Hamidreza Saber, University of Texas at Austin
Smit Patel, University of California Los Angeles, Los Angeles, CA
Lucido Luciano Ponce Mejia, LSU Health Sciences Center - New OrleansFollow
Naoki Kaneko, University of California Los Angeles, Los Angeles, CA
Viktor Szeder, University of California Los Angeles, Los Angeles, CA
May Nour, University of California Los Angeles, Los Angeles, CA
Reza Jahan, University of California Los Angeles, Los Angeles, CA
Satoshi Tateshima, University of California Los Angeles, Los Angeles, CA
Geoffrey Colby, University of California Los Angeles, Los Angeles, CA
Gary Duckwiler, University of California Los Angeles, Los Angeles, CA
Yalda Afshar, University of California Los Angeles, Los Angeles, CA

Document Type

Article

Publication Date

5-4-2023

Publication Title

PLoS ONE

Abstract

Introduction Aneurysmal subarachnoid hemorrhage (aSAH) is a rare event associated with significant pregnancy-associated maternal and neonatal morbidity and mortality. The optimal treatment strategy and clinical outcome of aSAH in pregnancy remains unclear. We aimed to investigate the treatment utilizations and outcomes of aSAH in pregnant people. Methods Using the 2010-2018 National Inpatient Sample, we identified all birth hospitalizations of women between ages of 18 to 45 associated with subarachnoid hemorrhage and aneurysm treatment were included. Multivariate analyses were used to evaluate the effect of pregnancy state, mode of treatment of aneurysms, severity of subarachnoid hemorrhage on mortality and discharge destination of this cohort. Trends in mode of treatment utilized for aneurysmal treatment in this time interval was evaluated. Results 13,351 aSAH with treatment were identified, of which 440 were associated with pregnancy. There was no significant difference in mortality or rate of discharge to home in pregnancy related hospitalization. Worse aSAH severity, chronic hypertension, and smaller hospital size was associated with significantly higher rate of mortality from aSAH during pregnancy. Worse aSAH severity was associated with lower rate of discharge to home. Like the non-pregnant cohort, the treatment of ruptured aneurysms in pregnancy are increasingly through endovascular approaches. The mode of treatment does not change the mortality or discharge destination. Conclusions Pregnancy does not alter mortality or the discharge destination for aSAH. Ruptured aneurysms during pregnancy are increasingly treated endovascularly. Mode of aneurysm treatment does not affect mortality or discharge destination in pregnancy.

PubMed ID

37141265

Volume

18

Issue

5

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Khatibi, Kasra; Saber, Hamidreza; Patel, Smit; Ponce Mejia, Lucido Luciano; Kaneko, Naoki; Szeder, Viktor; Nour, May; Jahan, Reza; Tateshima, Satoshi; Colby, Geoffrey; Duckwiler, Gary; and Afshar, Yalda, "Aneurysmal subarachnoid hemorrhage in pregnancy: National trends of treatment, predictors, and outcomes" (2023). School of Medicine Faculty Publications. 2049.
https://digitalscholar.lsuhsc.edu/som_facpubs/2049
10.1371/journal.pone.0285082