BackgroundPerinatal stroke occurs in approximately 1 in 1100 live births. Large
electronic health record (EHR) data can provide information on exposures
associated with perinatal stroke in a larger number of patients than is
achievable through traditional clinical studies. The objective of this study
is to assess prevalence and odds ratios of known and theorized comorbidities
with perinatal ischemic and hemorrhagic stroke.MethodsThe data for patients aged 0-28 days with a diagnosis of either ischemic or
hemorrhagic stroke were extracted from the Cerner Health Facts Electronic
Medical Record (EMR) database. Incidence of birth demographics and perinatal
complications were recorded. Odds ratios were calculated against a control
group.ResultsA total of 535 (63%) neonates were identified with ischemic stroke and 312
(37%) with hemorrhagic stroke. The most common exposures for ischemic stroke
were sepsis (n = 82, 15.33%), hypoxic injury (n = 61, 11.4%), and
prematurity (n = 49, 9.16%). The most common comorbidities for hemorrhagic
stroke were prematurity (n = 81, 26%) and sepsis (n = 63, 20%). No perinatal
ischemic stroke patients had diagnosis codes for cytomegalovirus disease.
Procedure and diagnosis codes related to critical illness, including
intubation and resuscitation, were prominent in both hemorrhagic (n = 46,
15%) and ischemic stroke (n = 45, 8%).ConclusionThis electronic health record–based study of perinatal stroke, the largest of
its kind, demonstrated a wide variety of comorbid conditions with ischemic
and hemorrhagic stroke. Sepsis, prematurity, and hypoxic injury are
associated with perinatal hemorrhagic and ischemic stroke, though prevalence
varies between types. Much of our data were similar to prior studies, which
lends validity to the electronic health record database in studying
perinatal stroke.