Pre‐eclampsia, gestational diabetes and hypertensive disorders in patients with intracranial aneurysms: A case–control study

Abstract

Background and purpose:The aim of this study was to define the prevalence of preeclampsia, gestational hypertension (HT), chronic HT, and gestational diabetes during pregnancy in a defined population of patients with saccular intracranial aneurysms (sIAs). Methods:We included all patients with sIA, first admitted to the Neurosurgery Department of Kuopio University Hospital from its defined catchment population between 1990 and 2015, who had given birth for the first time in 1990 or later. The patients' medical records were reviewed, and clinical data were linked with prescription drug usage, hospital diagnoses and causes of death, obtained from nationwide registries.The prevalences of pre-eclampsia, other hypertensive disorders and gestational diabetes in patients were compared with a matched control population (n = 324). In addition, the characteristics of sIA disease in patients with pre-eclampsia were compared to those of sIA patients without pre-eclampsia.Results: A total of 169 patients with sIA fulfilled the inclusion criteria. Of these, 22 (13%) had pre-eclampsia and 32 (19%) had other hypertensive disorders during pregnancy.In 324 matched controls who had given birth, the prevalence of pre-eclampsia was 5% (n = 15) and other hypertensive disorders were diagnosed in 10% (n = 34). There was no significant difference in prevalence of gestational diabetes (12% vs. 11%). Patients with sIA with pre-eclampsia more frequently had irregularly shaped aneurysms (p = 0•003).Conclusions: Pre-eclampsia was significantly more frequent in patients with sIA than in their population controls. Irregularly shaped aneurysms were more frequent in sIA patients with pre-eclampsia. Further studies are required to determine whether history of pre-eclampsia may indicate an elevated risk for sIA formation or rupture.

Aneurysm Prevalence and Quality of Life During Screening in Relatives of Patients With Unruptured Intracranial Aneurysms

“…Candidate predictors were prespecified based on literature: age at screening, female sex, type of kinship with index being siblings, smoking, excessive alcohol consumption, hypertension, hyperlipidemia, diabetes, hypertensive pregnancy complication, regular physical exercise, the interaction between female sex/smoking, and smoking/excessive alcohol consumption. 7,[20][21][22][23][24] The number of affected relatives was not included as a candidate predictor because all FDRs had only 1 FDR with UIA(s) (the index patient) during inclusion. 22 All candidate predictors were included in the full model, regardless of their association in the univariate analysis.…”

Prevalence of pre‐eclampsia in 265 patients with an intracranial aneurysm, 393 female relatives versus a control cohort: A case–control study

“…A possible connection between familial sIA disease and familial pre‐eclampsia has not been reported. In our previous study, pre‐eclampsia was more common in sIA patients than in their matched controls and sIA patients with pre‐eclampsia had more frequently irregularly‐shaped aneurysms [23]. The current study was conducted to verify the connection between pre‐eclampsia and sIA disease in an extended study population.…”

Should individual timeline and serial CT/MRI panels of all patients be presented in acute brain insult cohorts? A pilot study of 45 patients with decompressive craniectomy after aneurysmal subarachnoid hemorrhage

“…Six sIA family trees were illustrated with the timelines of two or three generations since the birth on a linear calendar year axis (1920-2020) [50]. In Kotikoski et al (2021), the linear age timelines of 22 female sIA patients indicated when pre-eclampsia was diagnosed in relation to the diagnosis of unruptured sIA, aSAH, and hypertension [48].…”