Risk factors of congenital hydrocephalus: a case-control study in a lower-middle-income country (Egypt)

Risk factors of congenital hydrocephalus: a case-control study in a lower-middle-income country (Egypt)

Hydrocephalus is the most common brain disorder in children and is more common in low- and middle-income countries. Research output on hydrocephalus remains sparse and of lower quality in low- and middle-income countries compared with high-income countries. Most studies addressing hydrocephalus epid...

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Bibliographic Details
Published in:Journal of neurosurgery. Pediatrics Vol. 31; no. 5; pp. 397 - 9
Main Authors: Ali, Taher M, Elwy, Reem, Abdelrazik, Bassante, Soliman, Mohamed A R, Alsawy, Mohamed F, Abdullah, Ahmed, Ahmed, Eman, Zaki, Shurouk, Salem, Amany A, Katri, Mohamed A, Elhamaky, Mostafa, Kandel, Haitham, Marei, Ahmed A, Menabbawy, Ahmed Al, Ghoul, Ahmed M F, Hafez, Ahmed A, Abdelbar, Sarah, Moharam, Reham Khaled, Hany, Ayman, Hasanin, Ahmed, Marx, Sascha, Fleck, Steffen, Baldauf, Jörg, Schroeder, Henry W S, Refaee, Ehab El, Zohdi, Ahmed
Format: Journal Article
Language:English
Published: United States 01-05-2023
Subjects:
Case-Control Studies
Child
Child, Preschool
Developing Countries
Egypt
Female
Humans
Hydrocephalus - etiology
Pregnancy
Retrospective Studies
Risk Factors
Egypt
epidemiology
risk factors
congenital hydrocephalus
socioeconomic
low- and lower-middle-income countries
maternal
paternal
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Summary:Hydrocephalus is the most common brain disorder in children and is more common in low- and middle-income countries. Research output on hydrocephalus remains sparse and of lower quality in low- and middle-income countries compared with high-income countries. Most studies addressing hydrocephalus epidemiology are retrospective registry studies entailing their inherent limitations and biases. This study aimed to investigate child-related, parental, and socioeconomic risk factors of congenital hydrocephalus (CH) in a lower-middle-income country. An investigator-administered questionnaire was used to query parents of patients with CH and controls who visited the authors' institution from 2017 until 2021. Patients with secondary hydrocephalus and children older than 2 years of age at diagnosis were excluded. Uni- and multivariable logistic regression was performed to identify the factors affecting CH development. Seven hundred forty-one respondents (312 cases and 429 controls) were included in this study. The authors showed that maternal diseases during pregnancy (OR 3.12, 95% CI 1.96-5.03), a lack of periconceptional folic acid intake (OR 1.92, 95% CI 1.32-2.81), being a housewife (OR 2.66, 95% CI 1.51-4.87), paternal illiteracy (OR 1.65, 95% CI 1.02-2.69), parental consanguinity (OR 3.67, 95% CI 2.40-5.69), a history of other CNS conditions in the family (OR 2.93, 95% CI 1.24-7.34), conceiving a child via assisted fertilization techniques (OR 3.93, 95% CI 1.57-10.52), and the presence of other congenital anomalies (OR 2.57, 95% CI 1.38-4.87) were associated with an independent higher odds of a child having CH. Conversely, maternal hypertension (OR 0.22, 95% CI 0.09-0.48), older maternal age at delivery (OR 0.93, 95% CI 0.89-0.97), and having more abortions (OR 0.80, 95% CI 0.67-0.95) were negatively correlated with CH. Multiple parental, socioeconomic, and child-related factors were associated with higher odds for developing CH. These results can be utilized to guide parental counseling and management, and direct social education and prevention programs.
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ISSN:1933-0707
1933-0715
DOI:10.3171/2022.12.PEDS22321