Risk factors for congenital hydrocephalus: a nationwide, register-based, cohort study

Munch, Tina Nørgaard; Rasmussen, Marie-Louise Hee; Wohlfahrt, Jan; Juhler, Marianne; Melbye, Mads

doi:10.1136/jnnp-2013-306941

Cited by 31 publications

(43 citation statements)

References 17 publications

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“…The same cohort study assessed PPI use during pregnancy and found that the relative risk of CH in children with exposure to PPI use during the first trimester of gestation was 2.35 compared with unexposed children. 19 Nonetheless, this risk was comparable to that for syndromic CH. Hence, this finding is not considered significant.…”

Section: Studymentioning

confidence: 90%

“…27 In a second cohort study, maternal diabetes and preeclampsia were investigated as risk factors but these associations did not reach significance. 19 Furthermore, prepregnancy obesity had a statistically significant association with CH in a meta-analysis study (OR 1.68).…”

Section: Lifestyle-modifiable Maternal Pathologiesmentioning

confidence: 99%

“…19 Given the widespread use of SSRIs and the evidence for adverse maternal (e.g., an increased risk of pregnancy-induced hypertension) 9 and neurodevelopmental effects, 2 this finding and its underlying biological and/or behavioral parameters warrant further investigation. A study by Munch et al in 2014 19 indicated that, unlike SSRIs, first-trimester exposure to PPIs does not confer a substantial risk for CH. Instead, deficiencies in maternal nutrition were postulated as indirect underlying mechanisms.…”

Section: 27mentioning

confidence: 99%

“…These risk factors include male sex, preterm birth (< 28 weeks), birth weight (below the 10th percentile or above the 90th percentile), and being firstborn. 19 However, little is known about the maternal environmental risk factors (i.e., environmental factors that directly affect the mother and possibly cause hydrocephalus by indirectly affecting the fetus) related to CH. Although a small number of cohort and observational studies have previously reported possible maternal environmental risk factors, there is a paucity of systematic reviews to comprehensively analyze this issue.…”

mentioning

confidence: 99%

“…Significant associations were shown for chronic maternal hypertension, maternal diabetes (pregestational and/or gestational), and preeclampsia in one large cohort study 27 but not in a second cohort study. 19 Obesity was significantly associated with CH in a meta-analysis. 24 Given that obesity, the metabolic syndrome, and related pathologies are reaching pandemic proportions, their impact on the development of hydrocephalus warrants further confirmation under both clinical and experimental settings.…”

mentioning

confidence: 99%

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Maternal environmental risk factors for congenital hydrocephalus: a systematic review

Kalyvas

Κalamatianos

Pantazi

et al. 2016

FOC

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OBJECTIVE Congenital hydrocephalus (CH) is one of the most frequent CNS congenital malformations, representing an entity with serious pathological consequences. Although several studies have previously assessed child-related risk factors associated with CH development, there is a gap of knowledge on maternal environmental risk factors related to CH. The authors have systematically assessed extrinsic factors in the maternal environment that potentially confer an increased risk of CH development. METHODS The Cochrane Library, MEDLINE, and EMBASE were systematically searched for works published between 1966 and December 2015 to identify all relevant articles published in English. Only studies that investigated environmental risk factors concerning the mother—either during gestation or pregestationally—were included. RESULTS In total, 13 studies (5 cohorts, 3 case series, 3 case-control studies, 1 meta-analysis, and 1 case report) meeting the inclusion criteria were identified. Maternal medication or alcohol use during gestation; lifestyle modifiable maternal pathologies such as obesity, diabetes, or hypertension; lack of prenatal care; and a low socioeconomic status were identified as significant maternal environmental risk factors for CH development. Maternal infections and trauma to the mother during pregnancy have also been highlighted as potential mother-related risk factors for CH. CONCLUSIONS Congenital hydrocephalus is an important cause of serious infant health disability that can lead to health inequalities among adults. The present study identified several maternal environmental risk factors for CH, thus yielding important scientific information relevant to prevention of some CH cases. However, further research is warranted to confirm the impact of the identified factors and examine their underlying behavioral and/or biological basis, leading to the generation of suitable prevention strategies.

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Section: Studymentioning

confidence: 90%

Section: Lifestyle-modifiable Maternal Pathologiesmentioning

confidence: 99%

Section: 27mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Maternal environmental risk factors for congenital hydrocephalus: a systematic review

Kalyvas

Κalamatianos

Pantazi

et al. 2016

FOC

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Association Between Proton Pump Inhibitor Use During Early Pregnancy and Risk of Congenital Malformations

et al. 2023

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ImportanceProton pump inhibitors (PPIs) are increasingly used during pregnancy; however, several observational studies have raised concerns about an increased risk of specific types of congenital malformations.ObjectiveTo examine the association between PPI exposure during early pregnancy and the risk of congenital malformations.Design, Setting, and ParticipantsThis population-based cohort study used data from the National Health Insurance Service–National Health Information Database of South Korea (2010-2020); sibling-controlled analyses were conducted to account for familial factors. A total of 2 696 216 pregnancies in women aged 19 to 44 years between June 1, 2011, and December 31, 2019, and their live-born infants were identified. Pregnant women who were exposed to known teratogens or who delivered infants with chromosomal abnormalities or genetic syndromes were excluded. Data on participant race and ethnicity were not collected because the National Health Information Database does not report this information.ExposuresProton pump inhibitor use during the first trimester.Main Outcomes and MeasuresPrimary outcomes were major congenital malformations, congenital heart defects, cleft palate, hydrocephalus, and hypospadias. The subtypes of major congenital malformations and congenital heart defects were evaluated as exploratory outcomes. Propensity score fine stratification was used to control for potential confounders, and a weighted generalized linear model was used to estimate relative risks with 95% CIs.ResultsOf 2 696 216 pregnancies (mean [SD] maternal age, 32.1 [4.2] years), 40 540 (1.5%; mean [SD] age, 32.4 [4.6] years) were exposed to PPIs during the first trimester. The absolute risk of major congenital malformations was 396.7 per 10 000 infants in PPI-exposed pregnancies and 323.4 per 10 000 infants in unexposed pregnancies. The propensity score–adjusted relative risks were 1.07 (95% CI, 1.02-1.13) for major congenital malformations, 1.09 (95% CI, 1.01-1.17) for congenital heart defects, 1.02 (95% CI, 0.72-1.43) for cleft palate, 0.94 (95% CI, 0.54-1.63) for hydrocephalus, and 0.77 (95% CI, 0.51-1.17) for hypospadias. In the sibling-controlled analyses, no associations were observed between PPI use and primary outcomes, including major congenital malformations (odds ratio, 1.05; 95% CI, 0.91-1.22) and congenital heart defects (odds ratio, 1.07; 95% CI, 0.88-1.30). A range of sensitivity analyses revealed results that were similar to the main findings.Conclusions and RelevanceIn this cohort study, the use of PPIs during early pregnancy was not associated with a substantial increase in the risk of congenital malformations, although small increased risks were observed for major congenital malformations and congenital heart defects; findings from sibling-controlled analyses revealed that PPIs were unlikely to be major teratogens. These findings may help guide clinicians and patients in decision-making about PPI use in the first trimester.

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Hydrocephalus

Adle‐Biassette

2018

Developmental Neuropathology

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Risk factors for congenital hydrocephalus: a nationwide, register-based, cohort study

Cited by 31 publications

References 17 publications

Maternal environmental risk factors for congenital hydrocephalus: a systematic review

Maternal environmental risk factors for congenital hydrocephalus: a systematic review

Association Between Proton Pump Inhibitor Use During Early Pregnancy and Risk of Congenital Malformations

Hydrocephalus

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