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Risk factors of intracranial haemorrhage in preeclampsia: a case–control study

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Abstract

Intracranial haemorrhage (ICH) is an uncommon but one of the most devastating and potentially fatal complications of preeclampsia. Most ICHs in pregnancy are reported in the absence of a vascular lesion, and severe systolic hypertension is thought to be an important risk factor even though many reports suggest that ICH can complicate preeclampsia even at lower blood pressure levels. In this case–control study of preeclamptic women, risk factors associated with ICH were compared in women who did and did not develop ICH. During the study period, ICH occurred in 1.8% (42/2167) pregnancies with preeclampsia, with 45.2% (n = 19/42) resulting in maternal mortality. HELLP syndrome (OR = 11.5; 95% CI 3.8–34.8), multiparity (OR 3.2; 95% CI 1.4–7.7), nausea/vomiting (OR = 3.6; 95% CI 1.4–9.3), and lower educational attainment (OR = 38.2; 95% CI 3.5–423.6) were associated with the increased probability of ICH. The incidence of caesarean birth (n = 29, 74.4% vs. n = 161, 34.5%) and neonatal mortality (n = 4, 13.3% vs. n = 17, 4.0%) were higher among preeclamptic who have ICH compared to those who did not have it. Improving awareness as well as early identification of those at risk of preeclampsia and complications can limit the impact of ICH among pregnant women with preeclampsia, especially in low- to middle-income countries.

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Anonymised data not published within this article will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, Jawaharlal Institute of Post-Graduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, India, 605006

    Anish Keepanasseril, Sathiya Priya Subburaj, Deepthi Nayak & Vandana Bojja

  2. Department of Radiodiagnosis, Jawaharlal Institute of Post-Graduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, India, 605006

    Sunitha Vellathussery Chakkalakkoombil

  3. Department of Neurology, Jawaharlal Institute of Post-Graduate Medical Education & Research (JIPMER), Dhanvantri Nagar, Puducherry, India, 605006

    Pradeep Pankajakshan Nair

Authors
  1. Anish Keepanasseril
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  2. Sathiya Priya Subburaj
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  3. Deepthi Nayak
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  4. Vandana Bojja
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  5. Sunitha Vellathussery Chakkalakkoombil
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  6. Pradeep Pankajakshan Nair
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Contributions

AK, SPS, DN, VB, SVC, and PPN conceived the study. All authors contributed to the design. SPS, DN, VB, and SVC carried out the data collection and guarantee data integrity. AK performed statistical analyses. SPS and PPN reviewed the analysis, and AK and SPS wrote the first draft. All authors contributed to revising and finalisation of the manuscript. AK (corresponding author) guarantees all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Corresponding author

Correspondence to Anish Keepanasseril.

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Ethical approval and informed consent waiver

This study was done as per the Institute Scientific Advisory and Ethical Committee (Human Studies), following the 1964 Helsinki declaration and its later amendments. Since this was a review based on records of the patients identified from the registers, a waiver of consent was approved by the Institute Ethics Committee for human studies (Certificate number: JIP/IEC/2018/308; dated 25.08.2018).

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The authors declare no competing interests.

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Keepanasseril, A., Subburaj, S.P., Nayak, D. et al. Risk factors of intracranial haemorrhage in preeclampsia: a case–control study. Neurol Sci 43, 6003–6010 (2022). https://doi.org/10.1007/s10072-022-06286-3

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  • DOI: https://doi.org/10.1007/s10072-022-06286-3

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