ABSTRACT NUMBER: ESOC2026A22 FETO-MATERNAL OUTCOMES OF PREGNANCY ASSOCIATED STROKE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Abstract Background and aims Pregnancy associated stroke (PAS) poses a significant threat to both maternal and neonatal health. The aim of this review is to synthesize evidence from the available studies to describe the feto-maternal outcomes of PAS. Methods We systematically searched six databases through April 3, 2025, and included observational and interventional studies reporting stroke during pregnancy or the puerperium, with maternal and/or neonatal outcomes. Studies were independently screened, and data were extracted and quality-assessed using standardized tools. Pooled prevalence was estimated using random-effects models, and mixed-effects meta-regression explored variability by study characteristics. Heterogeneity was assessed with I2 statistics and publication bias with Egger’s test. Results Across 24 studies, the pooled prevalence of PAS was 15 per 100000 participants (0.0150; 95% CI, 0.0020–0.1042), with a pooled case fatality rate of 85.8 per 100000 PAS cases (0.0858; 95% CI, 0.0534–0.1182) and a mortality rate of 2.7 per 100000 participants (0.0027; 95% CI, 0.0000–0.0060). Significant heterogeneity was observed across outcomes (I2 = 100%, 98.5%, and 98.1%). Narrative findings indicated prolonged hospitalization, increased cesarean delivery, and higher antenatal stroke occurrence. Six studies reported neonatal deaths, with a pooled neonatal mortality rate of 7 per 100000 deliveries (0.0007; 95% CI, 0.0000–0.0441). Conclusions PAS is associated with adverse maternal and fetal outcomes. However, the marked heterogeneity observed across studies highlights the necessity for further investigation to elucidate contextual outcome variations at both local and global levels. Conflict of interest Md Mahfuj Alam: nothing to disclose, Tanvir Ahmed: nothing to disclose, Shayla Saki: nothing to disclose, Imran Hossain Monju: nothing to disclose, Amr Ehab El-Qushayri: nothing to disclose, Al-Afroza Sultana: nothing to disclose, Mohammad Rashidul Hashan: nothing to disclose