ArticleJournal of the American Heart Association2024
Primary and Secondary Intracerebral Hemorrhage in Pregnant and Nonpregnant Young Adults by SMASH-UP Criteria.
Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- Predisposing Factors, Pathologies, and Precipitating Factors Causing Intracerebral Hemorrhage.Stroke · 2026Review
- Sex Differences in Young Adult Stroke Severity Using Linked Colorado-All Payer's Claims Database and the Get With The Guidelines-Stroke Registry.Journal of the American Heart Association · 2026Article
- Article
- Neurologic Complications of Pregnancy and Menopause.Continuum (Minneapolis, Minn.) · 2026Review
- Case Report:Frontiers in surgery · 2026Article
- Aggregated postpartum cerebral autoregulatory curves in normotensive individuals, preeclampsia with severe features, and superimposed preeclampsia with severe features.Physiological measurement · 2025Observational
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIntracerebral hemorrhage (ICH) is a major cause of maternal morbidity, but its pathophysiology is poorly characterized. We investigated characteristics of pregnancy-associated ICH (P-ICH), compared with ICH in similar aged nonpregnant adults of both sexes. METHODS AND
resultsWe performed a retrospective analysis of 134 adults aged 18 to 44 years admitted to our center with nontraumatic ICH from January 1, 2012, to December 31, 2021. We compared ICH characteristics among 3 groups: those with P-ICH (pregnant or within 12 months of end of pregnancy); nonpregnant women; and men. We categorized ICH pathogenesis according to a modified scheme, SMASH-UP (structural, medications, amyloid angiopathy, systemic, hypertension, undetermined, posterior reversible encephalopathy syndrome/reversible cerebral vasoconstriction syndrome), and calculated odds ratios and 95% CIs for primary (spontaneous small-vessel) ICH versus secondary ICH (structural lesions or coagulopathy related), using nonpregnant women as the reference. We also compared specific ICH pathogenesis by SMASH-UP criteria and functional outcomes between groups. Of 134 young adults with nontraumatic ICH, 25 (19%) had P-ICH, of which 60% occurred postpartum. Those with P-ICH had higher odds of primary ICH compared with nonpregnant women (adjusted odds ratio, 4.5 [95% CI, 1.4-14.7]). The odds of primary ICH did not differ between men and nonpregnant women. SMASH-UP pathogenesis for ICH differed significantly between groups (
conclusionsIn our cohort of young adults with ICH, 1 in 5 was pregnancy related. P-ICH differed in pathogenesis compared with non-pregnancy-related ICH in young adults, suggesting unique pathophysiology.
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