Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol

Abstract Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium (ASPP) mainly used European and American national healthcare databases, lacking detailed patient-level data and precise event timing. Aim (1) To identify the risk factors and prognostic...

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Main Authors: Zhongji Zhang, Zihan Yin, Tong Liu, Xiaolin Zhang, Qihang Zhang, Junlin Lu, Long Mu, Yang Dong, Juning Liu, Yi Xiao, Yanming Chen, Chenyang Song, Zengguang Wang, Yuheng Liu, Wei Ding, Li Zhang, Huaizhang Shi, Jingtao Qi, Bin Tang, Fei Wang, Pin Guo, Yongjun Tang, Mingsheng Yu, Wenjian Zheng, Qinglong He, Jian Yu, Aihua Zhu, Dazhao Fang, Gang Li, Yu Bai, Yushuang Zhang, Jiaxi Li, Yuli Wang, Faliang Gao, Yonggang Ma, Yifan Liu, Li Ma, Bao Yang, Yahui Zhao, Xun Ye, Qian Zhang, Yan Zhang, Xingju Liu, Jizong Zhao, on behalf of the ASPP Study Group
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Chinese Neurosurgical Journal
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Online Access:https://doi.org/10.1186/s41016-025-00396-5
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author Zhongji Zhang
Zihan Yin
Tong Liu
Xiaolin Zhang
Qihang Zhang
Junlin Lu
Long Mu
Yang Dong
Juning Liu
Yi Xiao
Yanming Chen
Chenyang Song
Zengguang Wang
Yuheng Liu
Wei Ding
Li Zhang
Huaizhang Shi
Jingtao Qi
Bin Tang
Fei Wang
Pin Guo
Yongjun Tang
Mingsheng Yu
Wenjian Zheng
Qinglong He
Jian Yu
Aihua Zhu
Dazhao Fang
Gang Li
Yu Bai
Yushuang Zhang
Jiaxi Li
Yuli Wang
Faliang Gao
Yonggang Ma
Yifan Liu
Li Ma
Bao Yang
Yahui Zhao
Xun Ye
Qian Zhang
Yan Zhang
Xingju Liu
Jizong Zhao
on behalf of the ASPP Study Group
author_facet Zhongji Zhang
Zihan Yin
Tong Liu
Xiaolin Zhang
Qihang Zhang
Junlin Lu
Long Mu
Yang Dong
Juning Liu
Yi Xiao
Yanming Chen
Chenyang Song
Zengguang Wang
Yuheng Liu
Wei Ding
Li Zhang
Huaizhang Shi
Jingtao Qi
Bin Tang
Fei Wang
Pin Guo
Yongjun Tang
Mingsheng Yu
Wenjian Zheng
Qinglong He
Jian Yu
Aihua Zhu
Dazhao Fang
Gang Li
Yu Bai
Yushuang Zhang
Jiaxi Li
Yuli Wang
Faliang Gao
Yonggang Ma
Yifan Liu
Li Ma
Bao Yang
Yahui Zhao
Xun Ye
Qian Zhang
Yan Zhang
Xingju Liu
Jizong Zhao
on behalf of the ASPP Study Group
author_sort Zhongji Zhang
collection DOAJ
description Abstract Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium (ASPP) mainly used European and American national healthcare databases, lacking detailed patient-level data and precise event timing. Aim (1) To identify the risk factors and prognostic factors for ASPP, (2) to assess the risk of recurrent stroke, particularly during subsequent pregnancies, and (3) to evaluate offspring prognosis. Design This study is a retrospective, observational, nationwide, multicenter research project planned to include 400 ASPP patients from 36 centers across 22 provinces in China, from 2015 to 2024. ASPP is defined as acute ischemic or hemorrhagic stroke during pregnancy or within 6 weeks postpartum, confirmed by neuroimaging. Two matched groups will be included for comparison: 400 pregnant/puerperal participants without a stroke history and 400 nonpregnant/puerperal participants with a recent stroke, matched by age and/or stroke etiology. Methods All participants will be followed up through telephone interviews. The initial follow-up is scheduled to take place between December 2024 and February 2025. The follow-up phase will consist of three rounds, each lasting 3 months and conducted every 3 years. Primary outcomes include unfavorable functional outcomes (mRS > 2 or EQ-5D index score < 0.7) at follow-up for Aim 1, recurrent strokes (neuroimaging-confirmed) for Aim 2, and neonatal asphyxia (Apgar scoring) and future development (ASQ-3) of offspring for Aim 3. Discussion The ASPP study is the first nationwide multicenter study to systematically evaluate the risk factors, prognosis, and risk of recurrent stroke in ASPP patients, particularly during subsequent pregnancies. This research may offer new insights into the long-term impacts of pregnancy-related stroke. Trial registration ClinicalTrials.gov (NCT06527807).
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spelling doaj-art-7f3f8ae0d2ea4ac886834a223edc6fd62025-08-20T02:05:46ZengBMCChinese Neurosurgical Journal2057-49672025-06-0111111110.1186/s41016-025-00396-5Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocolZhongji Zhang0Zihan Yin1Tong Liu2Xiaolin Zhang3Qihang Zhang4Junlin Lu5Long Mu6Yang Dong7Juning Liu8Yi Xiao9Yanming Chen10Chenyang Song11Zengguang Wang12Yuheng Liu13Wei Ding14Li Zhang15Huaizhang Shi16Jingtao Qi17Bin Tang18Fei Wang19Pin Guo20Yongjun Tang21Mingsheng Yu22Wenjian Zheng23Qinglong He24Jian Yu25Aihua Zhu26Dazhao Fang27Gang Li28Yu Bai29Yushuang Zhang30Jiaxi Li31Yuli Wang32Faliang Gao33Yonggang Ma34Yifan Liu35Li Ma36Bao Yang37Yahui Zhao38Xun Ye39Qian Zhang40Yan Zhang41Xingju Liu42Jizong Zhao43on behalf of the ASPP Study GroupDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Child and Adolescent Health Care, Children’s Hospital of Soochow UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan HospitalDepartment of Neurosurgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Women’s Healthcare, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalDepartment of Women’s Healthcare, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal HospitalDepartment of Neurosurgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Neurosurgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Neurosurgery, Tianjin Medical University General HospitalDepartment of Neurosurgery, Tianjin Medical University General HospitalDepartment of Neurosurgery, Tianjin Medical University General HospitalDepartment of Neurosurgery, Baotou Central HospitalDepartment of Neurosurgery, First Affiliated Hospital Harbin Medical UniversityDepartment of Neurosurgery, First Affiliated Hospital Harbin Medical UniversityDepartment of Neurosurgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Neurosurgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Neurosurgery, The Affiliated Hospital of Qingdao UniversityDepartment of Pediatric Respiratory, Xiangya Hospital, Central South UniversityDepartment of Neurosurgery, Tianjin Huanhu HospitalDepartment of Neurosurgery, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Neurosurgery, The Second Affiliated Hospital of Hainan Medical UniversityDepartment of Neurosurgery, The First Affiliated Hospital, University of Science and Technology of ChinaDepartment of Neurosurgery, Affiliated Hospital of Jiangnan UniversityDepartment of Neurosurgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical UniversityDepartment of Neurosurgery, Cangzhou Central Hospital, Hebei Medical UniversityDepartment of Neurosurgery, Sanbo Brain Hospital, Capital Medical UniversityDepartment of Pediatric, Guangyuan Central HospitalDepartment of Neurosurgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Neurosurgery, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical UniversityDepartment of Neurosurgery, Zhejiang Provincial People’s Hospital, Hangzhou Medical CollegeDepartment of Neurointerventional Surgery, Binzhou Medical University HospitalShanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical UniversityDepartment of Neurological Surgery, University of Pittsburgh Medical CenterDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background Previous studies on the risk factors and prognosis of acute stroke in pregnancy and puerperium (ASPP) mainly used European and American national healthcare databases, lacking detailed patient-level data and precise event timing. Aim (1) To identify the risk factors and prognostic factors for ASPP, (2) to assess the risk of recurrent stroke, particularly during subsequent pregnancies, and (3) to evaluate offspring prognosis. Design This study is a retrospective, observational, nationwide, multicenter research project planned to include 400 ASPP patients from 36 centers across 22 provinces in China, from 2015 to 2024. ASPP is defined as acute ischemic or hemorrhagic stroke during pregnancy or within 6 weeks postpartum, confirmed by neuroimaging. Two matched groups will be included for comparison: 400 pregnant/puerperal participants without a stroke history and 400 nonpregnant/puerperal participants with a recent stroke, matched by age and/or stroke etiology. Methods All participants will be followed up through telephone interviews. The initial follow-up is scheduled to take place between December 2024 and February 2025. The follow-up phase will consist of three rounds, each lasting 3 months and conducted every 3 years. Primary outcomes include unfavorable functional outcomes (mRS > 2 or EQ-5D index score < 0.7) at follow-up for Aim 1, recurrent strokes (neuroimaging-confirmed) for Aim 2, and neonatal asphyxia (Apgar scoring) and future development (ASQ-3) of offspring for Aim 3. Discussion The ASPP study is the first nationwide multicenter study to systematically evaluate the risk factors, prognosis, and risk of recurrent stroke in ASPP patients, particularly during subsequent pregnancies. This research may offer new insights into the long-term impacts of pregnancy-related stroke. Trial registration ClinicalTrials.gov (NCT06527807).https://doi.org/10.1186/s41016-025-00396-5Acute strokePregnancyPuerperiumClinical characteristicsPrognosisOffspring
spellingShingle Zhongji Zhang
Zihan Yin
Tong Liu
Xiaolin Zhang
Qihang Zhang
Junlin Lu
Long Mu
Yang Dong
Juning Liu
Yi Xiao
Yanming Chen
Chenyang Song
Zengguang Wang
Yuheng Liu
Wei Ding
Li Zhang
Huaizhang Shi
Jingtao Qi
Bin Tang
Fei Wang
Pin Guo
Yongjun Tang
Mingsheng Yu
Wenjian Zheng
Qinglong He
Jian Yu
Aihua Zhu
Dazhao Fang
Gang Li
Yu Bai
Yushuang Zhang
Jiaxi Li
Yuli Wang
Faliang Gao
Yonggang Ma
Yifan Liu
Li Ma
Bao Yang
Yahui Zhao
Xun Ye
Qian Zhang
Yan Zhang
Xingju Liu
Jizong Zhao
on behalf of the ASPP Study Group
Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
Chinese Neurosurgical Journal
Acute stroke
Pregnancy
Puerperium
Clinical characteristics
Prognosis
Offspring
title Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
title_full Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
title_fullStr Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
title_full_unstemmed Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
title_short Clinical characteristics and prognosis of acute stroke in pregnancy and puerperium (ASPP) patients and their offspring: a retrospective, observational, nationwide, multicenter study protocol
title_sort clinical characteristics and prognosis of acute stroke in pregnancy and puerperium aspp patients and their offspring a retrospective observational nationwide multicenter study protocol
topic Acute stroke
Pregnancy
Puerperium
Clinical characteristics
Prognosis
Offspring
url https://doi.org/10.1186/s41016-025-00396-5
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