To identify risk factors associated with the occurrence and prognosis of pregnancy-associated CVST and evaluate outcomes of subsequent pregnancies in affected women.
Approach:
Study Design: Retrospective case–control study conducted at a tertiary referral center in China from January 2010 to June 2024.
Participants: Included 20 pregnant or postpartum women diagnosed with CVST and 198 controls without CVST.
Data Collection: Clinical characteristics, laboratory indicators, neuroimaging findings, and treatment outcomes were compared between groups.
Follow-Up: Surviving patients were followed up for a median of 90.6 months to assess subsequent pregnancy rates and CVST recurrence.
Key Findings:
Of the 20 CVST patients, 7 (35.0%) occurred during early pregnancy and 13 (65.0%) in the postpartum period.
The early pregnancy group had higher rates of intracerebral hemorrhage (85.71% vs. 7.69%), cerebral infarction (57.14% vs. 30.77%), and mortality (42.86% vs. 7.69%) compared with the postpartum group.
Lower apolipoprotein A1 (APO-A1) levels were associated with CVST occurrence (OR = 0.005, 95% CI: 0.000–0.158, p = 0.003).
During follow-up, 3 of 16 surviving patients (18.75%) had subsequent pregnancies, and no CVST recurrence was observed.
Interpretation:
Early pregnancy CVST is associated with a more severe clinical course and higher mortality than postpartum CVST.
Limitations:
The study is limited by its retrospective design and small sample size.
Findings may not be generalizable to populations outside of the studied cohort.
Conclusion:
A prior history of CVST may not be an absolute contraindication to future pregnancy.
