BJOG. 2022 May 27. doi: 10.1111/1471-0528.17241. Online ahead of print.
ABSTRACT
OBJECTIVE: Idiopathic intracranial hypertension (IIH) predominantly affects women of reproductive age with obesity and women have a distinct profile of hyperandrogenism and insulin resistance. Polycystic ovary syndrome (PCOS) has an established adverse fertility phenotype that typically affects obese women. As IIH may impact reproductive health, we sought to evaluate fertility, gestational complications, and pregnancy outcome in IIH.
DESIGN: Prospective cohort study from English Hospital Episode Statistic dataset SETTING: English hospitals, United Kingdom POPULATION: Women aged 18-45 years seen in English hospitals between 1st April 2002 and 31st March 2019. Patients were required to have an IIH diagnosis and were compared to those with PCOS and general population female controls.
MAIN OUTCOME MEASURES: Pregnancies resulting in live births, complications of gestational diabetes and pre-eclampsia, and method of delivery.
RESULTS: Data was collected from 17587 IIH, 199633 PCOS, and 10947012 general population women. The live birth rate, adjusted for age, was significantly lower amongst women with IIH (54.1%) compared to PCOS (67.9%), p<0.0001 and general population (57.7%), p<0.0001. Pre-eclampsia and gestational diabetes risks were higher following a diagnosis of IIH (5.3-fold and 2.7-fold respectively, p<0.0001) compared to the general population controls. Following a diagnosis of IIH, elective caesarean section rates were more than twice that of general population (OR 2.4) and prior to a diagnosis of IIH (OR 2.2).
CONCLUSIONS: This data indicates there are lower age-adjusted total pregnancy rates, increased risk of pre-eclampsia and gestational diabetes and a doubling of elective caesarean section rates in those with a diagnosis of IIH.
PMID:35620863 | DOI:10.1111/1471-0528.17241
