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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 257-261    DOI: 10.31083/j.ceog.2020.02.5199
Original Research Previous articles | Next articles
Maternal age - a risk factor for congenital hydrocephalus
T. T. Kitova1, *(), B. D. Kitov2, E. H. Uchikova3, N. T. Ahmad4
1Department of Anatomy, Histology and Embryology, Bulgaria
2Department of Neurosurgery, Medical University of Plovdiv, Bulgaria
3Clinic of Obstetrics and Gynecology, University Hospital "St. George", Plovdiv, Bulgaria
4Medical University of Plovdiv, Bulgaria
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Abstract  Aims: The aim of this study was to determine whether maternal age on its own and, in combination with other risk factors and associated anomalies, are risk factors for the development of hydrocephalus. Materials and Methods: One-hundred-eighty-two fetuses with congenital hydrocephalus (CH) were studied by fetal autopsy. Sixty-nine of them (38%) had Isolated Hydrocephalus (IH) and 113 (62%) -Associated Hydrocephalus (AH). Most fetuses (172) were received over a period of three years (2006-2009), out of 21,316 births at an Embryo-Fetopathologic Clinic, the Centre for Maternity and Neonatology, Tunis, Tunisia. The remaining ten fetuses were obtained from an Obstetrics and Gynecology Clinic at University Hospital, Plovdiv, Bulgaria in 2016, out of 2, 104 births. Results: When the mother’s age is over 40 years and consanguinity is present, the risks of CH and associated hydrocephalus is increased [OR = 18.750 CI (1.162-302.544)], [OR = 11.667 CI (0.924-147.298)]. The risk of CH is 35-fold greater with maternal age over 40 years and lissencephaly [OR = 35,000 CI (1.743-702.993)]. There is also moderate risk of CH with trisomies and maternal age over 38 years [OR = 12.740 CI (3.402-7.710)]. Conclusions: At a time when the number of women giving birth for the first time after the age of 35 years increases, maternal age should be considered a risk factor for the occurrence of CH. This possibility is increased when combined with other maternal or exogenous risk factors, and in the presence of associated malformations, such as aqueductal stenosis, polygyria, lissencephaly, and trisomies. Conclusion: A maternal age over 35 years should be considered a risk factor for the occurrence of hydrocephalus.
Key words:  Congenital hydrocephalus      Fetopathological examination      Maternal age      Risk factors      Trisomies     
Published:  15 April 2020     
*Corresponding Author(s):  T. T. Kitova     E-mail:  tanyakitova@yahoo.com

Cite this article: 

T. T. Kitova, B. D. Kitov, E. H. Uchikova, N. T. Ahmad. Maternal age - a risk factor for congenital hydrocephalus. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 257-261.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5199     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/257

Table 1  — Distribution of congenital hydrocephalus according to the age of mothers.
MOTHER’S AGE ISOLATED HYDROCEPHALUS ASSOCIATED HYDROCEPHALUS TOTAL
n % n % n %
16-26 years 8 11.8 24 22.0 32 18.1
27-35 years 44 64.7 64 58.7 108 61.0
36-50 years 16 23.5 21 19.3 37 20.9
TOTAL 68 100.0 109 100.0 177 100.0
Table 2  — Distribution of congenital hydrocephalus by incidence of consanguinity in the fetus.
CONSANGUINITY ISOLATED HYDROCEPHALUS ASSOCIATED HYDROCEPHALUS TOTAL
n % n % n %
No 57 82.6 78 69.0 135 74.2
Yes 12 17.4 35 31.0 47 25.8
TOTAL 69 100.0 113 100.0 182 100.0
Figure 1.  — Distribution of congenital hydrocephalus by degree of consanguinity in the fetus.

Table 3  — Maternal-endogenous risk factors for congenital hydrocephalus.
ENDOGENOUS RISK FACTORS ISOLATED HYDROCEPHALUS ASSOCIATED HYDROCEPHALUS TOTAL
n % n % n %
No impact of risk factors 63 91.3 102 90.3 165 90.7
Under the influence of risk factors 6 8.7 11 9.7 17 9.3
TOTAL 69 100.0 113 100.0 182 100.0
Table 4  — Distribution of brain abnormalities associated with congenital hydrocephalus.
BRAIN ABNORMALITIES ASSOCIATED WITH CH n % OF THE ANOMALY STUDIES % OF ALL
Polygyria 12 14.2 10.6
Lissencephaly 2 2.3 1.8
Corpus Callosum Agenesis 18 21.2 15.9
Vermis Cerebellar Agenesis 19 22.3 16.8
Cerebellar Hypoplasia 25 29.4 22.1
Aqueductal Stenosis 5 5.8 4.42
Holoprosencephaly 1 1.2 0.9
Choroid Plexus Cysts 2 2.4 1.8
TOTAL 85 100.0 75.22
Table 5  — Congenital hydrocephalus with lethal outcome and maternal age.
НС INDICATORS GROUPS ≤ 40 years ≥ 40years TOTAL р Fisher OR
(CI)
n % n % n %
Consanguinity third degree No 140 95.9 6 4.1 146 100.0 0.018 0.135 11.667
(0.924-147.298
Yes 2 66.7 1 33.3 3 100.0
Total 142 95.3 7 4.7 149 100.0
AH Consanguinity third degree n 75 97.4 2 2.6 77 100.0 0.006 0.110 18.750
(1.162-302.544
Yes 2 66.7 1 33.3 3 100.0
Total 77 96.3 3 3.8 80 100.0
НС Indicators GROUPS ≤ 40 years ≥ 40 years TOTAL р Fisher OR
(CI)
n % n % n %
Lissencephaly n 105 99.1 1 0.9 106 100.0 0.000 0.072 35.000
(1.743-702.993)
Yes 3 75.0 1 25.0 4 100.0
Total 108 98.2 2 1.8 110 100.0
НС Indicators GROUPS ≤ 38 years ≥ 38 years TOTAL р Fisher OR (CI)
n % n % n %
Trisomy n 91 90.1 10 9.9 101 100.0 0.000 0.000 12.740
(3.402-7.710)
Yes 5 41.7 7 58.3 12 100.0
Total 96 85 17 15 113 100.0
НС Indicators GROUPS ≤ 35 years ≥ 35 years TOTAL р Fisher OR (CI)
n % n % n %
Polygyria no 82 92.1 7 7.9 89 100.0 0.027 0.67 4.894 (1.094-13.94)
yes 15 75.0 5 25.0 20 100.0
total 97 89.1 12 11.0 109 100.0
НС Indicators GROUPS OTHER 16-26 years TOTAL Р Fisher OR (CI)
n % n % n %
AS n 84 97.7 2 2.3 86 100.0 0.029 0.056 6.300
(0.986-40.246)
yes 20 87.0 3 13.0 23 100.0
total 104 95.4 5 4.6 109 100.0
Figure 2.  — Distribution of the risk of association between congenital hydrocephalus and other abnormalities.

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