Abstract 122: Maternal Stroke and Malnutrition: a Cross‐Sectional Analysis of the National Inpatient Sample

Introduction Malnutrition is present on admission in approximately 20% of stroke patients, contributing to stroke morbidity and mortality. While stroke during the peripartum period is rare, it accounts for 18% of strokes in women aged 18‐35. Additionally, health inequities in stroke incidence persist, with previous studies reporting that Black mothers had 50% higher odds of having a stroke than white mothers. The objective of the current study was to (a) determine the prevalence of malnutrition in women during the peripartum hospital stay and (b) calculate the odds of ischemic and hemorrhagic stroke in women with malnutrition. Methods We utilized the National Inpatient Sample (NIS) years 2016‐2020, selecting women aged 18‐44 with a pregnancy related ICD‐10 code. The presence of ICD‐10 codes for malnutrition were used to determine malnutrition status. Weighted logistic regression models were fitted with ischemic stroke and hemorrhagic stroke as the outcomes; covariates included age, socioeconomic status, stroke history, hypertensive disorders of pregnancy, and having obesity. All analyses were completed in SAS v9.4. Results Malnutrition was associated with stroke occurrence, with 35 times increased odds of ischemic stroke in women with malnutrition as compared to women without malnutrition (aOR=35.10; 95% CI: 18.89, 65.22). History of stroke (aOR: 39.92; 95% CI: 23.83, 57.18), low and middle socioeconomic status (low SES aOR: 1.41; 95% CI: 1.10‐1.81; middle SES aOR: 1.34; 95% CI: 1.04‐1.72), hypertensive disorders of pregnancy (OR: 2.75; 95% CI: 2.20, 3.44), age (aOR: 1.05; 95% CI: 1.03, 1.07), and race (aOR: 1.33; 95% CI: 1.04, 1.70) were also significant covariates in this model. Obesity (aOR: 1.12; 95% CI: 0.85‐1.48) was not associated with ischemic stroke. Malnutrition was also two times more prevalent in black women as it was in white women in this sample (cOR=2.09, 95% CI: 1.88, 2.33). Conclusions Malnutrition has a significant impact on stroke occurrence during peripartum period, increasing the odds of stroke by 35 times. This relationship could contribute to the overall disparity in maternal morbidity and mortality between black and white mothers, since black women have 50 percent higher odds of stroke and two times higher odds of malnutrition. The overall higher prevalence of malnutrition among Black women could contribute to greater stroke risk in that population.