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Abstract
Background and Objectives特发性颅内高血压(IIH)大多数泰pically occurs in women of childbearing age with increased weight as a key risk factor for development or exacerbation of the disease. Pregnancy is common in this group of patients. The longer-term effect of pregnancy on IIH has not been established and was the aim of this study.
MethodsA prospective cohort study (IIH Life) recruited consecutive patients with IIH between 2012 and 2021 and evaluated outcomes including vision (logarithm of the minimum angle of resolution visual acuity, Humphrey visual field perimetric mean deviation, and optical coherence tomography [OCT] imaging) and headache. Four cohorts were evaluated: those with IIH diagnosed for the first time while pregnant, those with established IIH who became pregnant, those with a pregnancy prior to their diagnosis of IIH, and those with IIH who never became pregnant.
ResultsThree hundred seventy-seven people with IIH agreed to participate in the IIH Life maternal health study. Mean follow-up was 17.5 months (SD 20.5). IIH diagnosed in pregnancy was rare. Patients diagnosed with IIH while pregnant had greater papilledema (mean OCT total retinal thickness +11.59 µm/mo [95% CI 1.25–21.93]), although they had comparable visual field and acuity measures compared with those with established IIH who became pregnant during their disease course (−1.2 µm/mo [95% CI −2.6 to 0.21]). In those with established IIH, pregnancy did not adversely affect visual or headache outcomes over time, and the trajectory was akin to those with IIH who never had a pregnancy. Headache outcomes showed variability reflecting the IIH cohort as a whole.
DiscussionA diagnosis of IIH while pregnant was rare but associated with more severe papilledema. Long-term visual outcomes in IIH were analogous irrespective of the timing of the pregnancy. These data are reassuring; however, close vigilance of IIH clinical features during pregnancy is recommended.
Glossary
- BMI=
- body mass index;
- GCL=
- ganglion cell layer;
- HIT-6=
- Headache Impact Test 6;
- ICP=
- intracranial pressure;
- IIH=
- idiopathic intracranial hypertension;
- logMAR=
- logarithm of the minimum angle of resolution;
- OCT=
- optical coherence tomography;
- PMD=
- perimetric mean deviation;
- RNFL=
- retinal nerve fiber layer thickness;
- TRT=
- total retinal thickness;
- UHB=
- University Hospitals Birmingham
Footnotes
Go toNeurology.org/Nfor full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Associate Editor Rebecca Burch, MD.
CME Course:NPub.org/cmelist
- ReceivedAugust 11, 2022.
- Accepted in final formDecember 7, 2022.
- 书面作业由联邦雇员Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
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