The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea
Abstract Background Physiologic changes during pregnancy affect the development of postpartum cerebrovascular disease (CVD) in women with Moyamoya disease. Due to the rare prevalence of Moyamoya disease and its large regional variations, large-scale based studies on the risk of CVD after delivery ha...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04718-8 |
| _version_ | 1818213509966594048 |
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| author | Yeonseong Jeong Yun Ji Jung Eunjin Noh Sungyeon Ha Jeongeun Hwang Geum Joon Cho Min-Jeong Oh Young-Han Kim |
| author_facet | Yeonseong Jeong Yun Ji Jung Eunjin Noh Sungyeon Ha Jeongeun Hwang Geum Joon Cho Min-Jeong Oh Young-Han Kim |
| author_sort | Yeonseong Jeong |
| collection | DOAJ |
| description | Abstract Background Physiologic changes during pregnancy affect the development of postpartum cerebrovascular disease (CVD) in women with Moyamoya disease. Due to the rare prevalence of Moyamoya disease and its large regional variations, large-scale based studies on the risk of CVD after delivery have not been conducted. This study aimed to evaluate whether women with Moyamoya disease have an increased risk of CVD after delivery. Methods Research data was collected from the National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who delivered in Korea from 2007 to 2014 were enrolled in this study. We classified women as having CVD if they were diagnosed with any of the following conditions between delivery and December 31, 2016; cerebral infarction (I63.X in the International Classification of Diseases-10th Revision [ICD-10]) and/or intracranial hemorrhage (I61.X, I62.X in ICD-10) and/or subarachnoid hemorrhage (I60.X in ICD-10). Women with Moyamoya disease were identified as having I67.5 in ICD-10. We matched the study cohort by the ratio of 1:10 to analyze the risk CVD occurrence. The matching technique applied in this study was based on the variables of age and parity. To evaluate the adjusted hazard ratio (HR) for CVD in women with Moyamoya disease, we used multivariate Cox proportional hazard regression. Results Among a total of 3,611,216 Korean women who underwent delivered, we identified 412 women with Moyamoya disease diagnosis and 1420 age- and parity-matched women without Moyamoya disease (control). Compared to the control group, women with Moyamoya disease had a significantly higher rate of Cesarean section, overt DM, and essential hypertension (all p < 0.0001). Among women with Moyamoya disease, 55 (13.35%) women developed CVD within the follow-up postpartum period. The presence of Moyamoya disease was associated with an increased risk of CVD after delivery (adjusted HR 37.42; 95% confidence interval (CI) 17.50-80.02 within 2.3 years) after adjusting for pregnancy-induced hypertension, gestational diabetes mellitus, pregestational diabetes, chronic hypertension. Conclusion This population based study showed that the occurrence rate of CVD after delivery was higher in women with Moyamoya disease than in those without. Therefore, careful and long-term postpartum surveillance is required for women with Moyamoya disease. |
| first_indexed | 2024-12-12T06:05:26Z |
| format | Article |
| id | doaj.art-31e174704fcf4160b330914aea8c9b8f |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-12T06:05:26Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-31e174704fcf4160b330914aea8c9b8f2022-12-22T00:35:18ZengBMCBMC Pregnancy and Childbirth1471-23932022-05-012211810.1186/s12884-022-04718-8The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South KoreaYeonseong Jeong0Yun Ji Jung1Eunjin Noh2Sungyeon Ha3Jeongeun Hwang4Geum Joon Cho5Min-Jeong Oh6Young-Han Kim7Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Yonsei University Health SystemDepartment of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Yonsei University Health SystemKorea University Guro Hospital Smart Healthcare CenterGraduate School of Statistics, Sungkyunkwan UniversityDepartment of Biomedical Research Center, Korea University Guro HospitalDepartment of Obstetrics and Gynecology, Korea University College of MedicineDepartment of Obstetrics and Gynecology, Korea University College of MedicineDepartment of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Yonsei University Health SystemAbstract Background Physiologic changes during pregnancy affect the development of postpartum cerebrovascular disease (CVD) in women with Moyamoya disease. Due to the rare prevalence of Moyamoya disease and its large regional variations, large-scale based studies on the risk of CVD after delivery have not been conducted. This study aimed to evaluate whether women with Moyamoya disease have an increased risk of CVD after delivery. Methods Research data was collected from the National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who delivered in Korea from 2007 to 2014 were enrolled in this study. We classified women as having CVD if they were diagnosed with any of the following conditions between delivery and December 31, 2016; cerebral infarction (I63.X in the International Classification of Diseases-10th Revision [ICD-10]) and/or intracranial hemorrhage (I61.X, I62.X in ICD-10) and/or subarachnoid hemorrhage (I60.X in ICD-10). Women with Moyamoya disease were identified as having I67.5 in ICD-10. We matched the study cohort by the ratio of 1:10 to analyze the risk CVD occurrence. The matching technique applied in this study was based on the variables of age and parity. To evaluate the adjusted hazard ratio (HR) for CVD in women with Moyamoya disease, we used multivariate Cox proportional hazard regression. Results Among a total of 3,611,216 Korean women who underwent delivered, we identified 412 women with Moyamoya disease diagnosis and 1420 age- and parity-matched women without Moyamoya disease (control). Compared to the control group, women with Moyamoya disease had a significantly higher rate of Cesarean section, overt DM, and essential hypertension (all p < 0.0001). Among women with Moyamoya disease, 55 (13.35%) women developed CVD within the follow-up postpartum period. The presence of Moyamoya disease was associated with an increased risk of CVD after delivery (adjusted HR 37.42; 95% confidence interval (CI) 17.50-80.02 within 2.3 years) after adjusting for pregnancy-induced hypertension, gestational diabetes mellitus, pregestational diabetes, chronic hypertension. Conclusion This population based study showed that the occurrence rate of CVD after delivery was higher in women with Moyamoya disease than in those without. Therefore, careful and long-term postpartum surveillance is required for women with Moyamoya disease.https://doi.org/10.1186/s12884-022-04718-8Moyamoya diseaseCerebrovascular diseasePregnancyNationwide large-scale study |
| spellingShingle | Yeonseong Jeong Yun Ji Jung Eunjin Noh Sungyeon Ha Jeongeun Hwang Geum Joon Cho Min-Jeong Oh Young-Han Kim The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea BMC Pregnancy and Childbirth Moyamoya disease Cerebrovascular disease Pregnancy Nationwide large-scale study |
| title | The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea |
| title_full | The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea |
| title_fullStr | The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea |
| title_full_unstemmed | The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea |
| title_short | The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea |
| title_sort | risk for future cerebrovascular disease in pregnant women with moyamoya disease a nationwide population based study in south korea |
| topic | Moyamoya disease Cerebrovascular disease Pregnancy Nationwide large-scale study |
| url | https://doi.org/10.1186/s12884-022-04718-8 |
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