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IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuro-Ophthalmology Pub Date : 2024-12-11 DOI:10.1097/WNO.0000000000002296

Jacqueline K Shaia, Ilene P Trinh, Taseen A Alam, Jenna R Rock, Jeffrey Y Chu, David C Kaelber, Rishi P Singh, Katherine E Talcott, Devon A Cohen

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引用次数: 0

摘要

背景：特发性颅内高压（IIH）主要发生在超重或肥胖的育龄妇女身上。由于这个年龄段的女性都会怀孕，因此了解 IIH 与怀孕之间是否存在关联非常重要。本研究旨在确定妊娠期 IIH 的发病率，以及 IIH 是否与妊娠期高血压疾病（HDP）有关：在这项回顾性队列分析中，研究人员使用一家三级医疗中心的电子健康记录来识别 IIH 患者。纳入的患者诊断代码为 IIH 或乳头水肿，就诊时间为 2012 年 6 月 1 日至 2023 年 9 月 1 日。在符合修订后的 Dandy 诊断标准后，对患者在诊断 IIH 之前、期间或之后的妊娠史以及高血压疾病（包括子痫前期/子痫、HELLP（溶血、肝酶升高、血小板计数低）综合征和高血压）进行评估。将 IIH 患者与无 IIH 的对照组相比，计算出了发病率和风险比 (RR)。为了在控制肥胖和偏头痛的同时证实这些结果，我们利用拥有 1 亿多患者的 TriNetX 平台设计了一项病例对照分析，评估 IIH 患者患 HDP 的几率：结果：共发现 292 例 IIH 患者曾有过妊娠史，其中 7% 在妊娠期间新发 IIH。与对照组相比，患者发生包括子痫（RR：12.92，95% CI：5.35，31.22）、子痫前期（2.39，CI：1.84，3.10）和 HELLP 综合征（6.72，CI：2.16，20.90）在内的所有 HDP 的风险均有所增加。IIH 患者宫外孕和流产的风险也更高（P < 0.05）。在控制肥胖和偏头痛的情况下，患者发生所有HDP和子痫的几率仍然增加（P < 0.05）：结论：IIH患者发生HDP的风险增加，尤其是子痫和HELLP综合征，因此需要在妊娠期间加强对这些患者的临床监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Idiopathic Intracranial Hypertension Is Associated With an Increased Risk of Hypertensive Pregnancy Disorders.

Background: Idiopathic intracranial hypertension (IIH) mainly occurs in women of a reproductive age who are overweight or obese. As pregnancy occurs in this age group, it is important to understand whether there are associations between IIH and pregnancy. The purpose of this study was to determine the incidence of IIH development during a pregnancy and whether IIH is associated with hypertensive disorders of pregnancy (HDP).

Methods: In this retrospective cohort analysis, electronic health records from a tertiary care center were used to identify patients with IIH. Patients who had a diagnostic code for IIH or papilledema and were seen between June 1, 2012, and September 1, 2023, were included. After meeting the revised Dandy diagnostic criteria, patients were evaluated for a history of pregnancy before, during, or after their IIH diagnosis and hypertensive disorders including preeclampsia/eclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and hypertension. Incidence and risk ratios (RR) were calculated comparing patients with IIH with controls without IIH. To corroborate these results while controlling for obesity and migraine, the TriNetX platform housing more than 100 million patients was used to design a case-control analysis evaluating the odds of an IIH patient having an HDP.

Results: Two hundred ninety-two IIH patients with a prior pregnancy were identified of which 7% developed new onset IIH during pregnancy. Patients had increased risks of all HDP including eclampsia (RR: 12.92, 95% CI: 5.35, 31.22), preeclampsia (2.39, CI 1.84, 3.10), and HELLP syndrome (6.72, CI 2.16, 20.90) compared with controls. Patients with IIH also had higher risks of ectopic pregnancies and miscarriages (P < 0.05). When controlling for obesity and migraine, patients continued to have increased odds of all HDP and eclampsia (P < 0.05).

Conclusions: Patients with IIH had an increased risk of having an HDP, especially eclampsia and HELLP syndrome highlighting a need for increased clinical monitoring of these patients during pregnancy.

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来源期刊

Journal of Neuro-Ophthalmology 医学-临床神经学

CiteScore

2.80

自引率

13.80%

发文量

593

审稿时长

6-12 weeks

期刊介绍： The Journal of Neuro-Ophthalmology (JNO) is the official journal of the North American Neuro-Ophthalmology Society (NANOS). It is a quarterly, peer-reviewed journal that publishes original and commissioned articles related to neuro-ophthalmology.