Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study

BackgroundPerinatal cerebral infarction (PCI) is a common cause of neurological complications in neonates. This study aimed to compare the clinical characteristics and risk factors of perinatal arterial ischemic stroke (PAIS) and perinatal hemorrhagic stroke (PHS) to inform early recognition and int...

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Main Authors: Chongchong Liu, Yi Zhang, Run Yang, Shiwen Xia
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1540173/full
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author Chongchong Liu
Yi Zhang
Run Yang
Shiwen Xia
author_facet Chongchong Liu
Yi Zhang
Run Yang
Shiwen Xia
author_sort Chongchong Liu
collection DOAJ
description BackgroundPerinatal cerebral infarction (PCI) is a common cause of neurological complications in neonates. This study aimed to compare the clinical characteristics and risk factors of perinatal arterial ischemic stroke (PAIS) and perinatal hemorrhagic stroke (PHS) to inform early recognition and intervention strategies.MethodsWe conducted a retrospective analysis of 124 neonates diagnosed with PCI, admitted to the neonatal intensive care unit (NICU) between June 2015 and December 2023. The neonates were divided into two groups—PAIS and PHS—based on clinical symptoms and cranial imaging findings.ResultsOf the 124 patients, 87 (70.2%) were diagnosed with PAIS, while 37 (29.8%) had PHS. Clonic seizures were observed in 78 cases (62.9%), with apnoea noted in 11 cases (12.6%) within the PAIS group and jaundice in 8 cases (21.6%) within the PHS group. Lesions were primarily located in the left cerebral hemisphere in 53 cases (41.4%), whereas PHS lesions frequently involved the thalamus and basal ganglia (12 cases, 32.4%). Statistical analysis revealed significant differences in risk factors between the PAIS and PHS groups. The PAIS group had a higher rate of conversion from failed trial of labor to cesarean section compared to the PHS group (P = 0.012). Additionally, postnatal thrombocytopenia was more commonly associated with the PHS group than the PAIS group (P = 0.034).ConclusionsOur findings indicate that PAIS is more prevalent within the studied population, with a notable correlation between failed labor trials resulting in cesarean sections and the incidence of PAIS. This suggests a potential link between complications during labor and the occurrence of ischemic strokes. In contrast, postnatal thrombocytopenia was found to be significantly more common in the PHS group, indicating a possible association between low platelet counts and hemorrhagic strokes.
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spelling doaj-art-5e4cad94a68b40169453b5a3db95715b2025-08-20T03:28:21ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.15401731540173Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative studyChongchong Liu0Yi Zhang1Run Yang2Shiwen Xia3Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Pediatric Neurology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackgroundPerinatal cerebral infarction (PCI) is a common cause of neurological complications in neonates. This study aimed to compare the clinical characteristics and risk factors of perinatal arterial ischemic stroke (PAIS) and perinatal hemorrhagic stroke (PHS) to inform early recognition and intervention strategies.MethodsWe conducted a retrospective analysis of 124 neonates diagnosed with PCI, admitted to the neonatal intensive care unit (NICU) between June 2015 and December 2023. The neonates were divided into two groups—PAIS and PHS—based on clinical symptoms and cranial imaging findings.ResultsOf the 124 patients, 87 (70.2%) were diagnosed with PAIS, while 37 (29.8%) had PHS. Clonic seizures were observed in 78 cases (62.9%), with apnoea noted in 11 cases (12.6%) within the PAIS group and jaundice in 8 cases (21.6%) within the PHS group. Lesions were primarily located in the left cerebral hemisphere in 53 cases (41.4%), whereas PHS lesions frequently involved the thalamus and basal ganglia (12 cases, 32.4%). Statistical analysis revealed significant differences in risk factors between the PAIS and PHS groups. The PAIS group had a higher rate of conversion from failed trial of labor to cesarean section compared to the PHS group (P = 0.012). Additionally, postnatal thrombocytopenia was more commonly associated with the PHS group than the PAIS group (P = 0.034).ConclusionsOur findings indicate that PAIS is more prevalent within the studied population, with a notable correlation between failed labor trials resulting in cesarean sections and the incidence of PAIS. This suggests a potential link between complications during labor and the occurrence of ischemic strokes. In contrast, postnatal thrombocytopenia was found to be significantly more common in the PHS group, indicating a possible association between low platelet counts and hemorrhagic strokes.https://www.frontiersin.org/articles/10.3389/fped.2025.1540173/fullischemic strokehemorrhagic strokerisk factorscesarean deliverythrombocytopenia
spellingShingle Chongchong Liu
Yi Zhang
Run Yang
Shiwen Xia
Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
Frontiers in Pediatrics
ischemic stroke
hemorrhagic stroke
risk factors
cesarean delivery
thrombocytopenia
title Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
title_full Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
title_fullStr Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
title_full_unstemmed Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
title_short Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study
title_sort clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke a comparative study
topic ischemic stroke
hemorrhagic stroke
risk factors
cesarean delivery
thrombocytopenia
url https://www.frontiersin.org/articles/10.3389/fped.2025.1540173/full
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