title: A systematic review of the risks factors associated with the onset and natural progression of hydrocephalus.
abstract: The purpose of this study was to systematically assess and synthesize the world literature on risk factors for the onset and natural progression of hydrocephalus, thereby providing a basis for policy makers to identify appropriate risk management measures to mitigate the burden of disease in Canada. Evidence for risk factors was limited for both onset and progression. Two meta-analyses that examined a risk factor for onset met the inclusion criteria. One found a significant protective effect of prenatal vitamins among case control studies, but not cohort/randomized controlled trials (RCTs). The second found maternal obesity to be a significant risk factor for congenital hydrocephalus. Significant risk factors among 25 observational studies included: biological (multiple births, maternal parity, common cold with fever, maternal thyroid disease, family history, preterm birth, hypertension, ischemic heart disease, ischemic ECG changes, higher cerebrospinal fluid protein concentration following vestibular schwannoma); lifestyle (maternal obesity, high-density lipoprotein (HDL) cholesterol, maternal diabetes, maternal age), healthcare-related (caesarean section, interhospital transfer, drainage duration following subarachnoid hemorrhage, proximity to midline for craniectomy following traumatic brain injury); pharmaceutical (prenatal exposure to: tribenoside, metronidazole, anesthesia, opioids); and environmental (altitude, paternal occupation). Three studies reported on genetic risk factors: no significant associations were found. There are major gaps in the literature with respect to risk factors for the natural progression of hydrocephalus. Only two observational studies were included and three factors reported. Many risk factors for the onset of hydrocephalus have been studied; for most, evidence remains limited or inconclusive. More work is needed to confirm any causal associations and better inform policy.
authors.affiliation: Newfoundland and Labrador Centre for Health Information, 70 O'Leary Avenue St. John's, NL A1B 2C7, Canada. Electronic address: stephanie.walsh@nlchi.nl.ca.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Walsh
authors.affiliation: School of Pharmacy, Memorial University of Newfoundland, Health Science Centre, St. John's, NL A1B 3V6, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Donnan
authors.affiliation: Newfoundland and Labrador Centre for Health Information, 70 O'Leary Avenue St. John's, NL A1B 2C7, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Morrissey
authors.affiliation: Health Sciences Library, University of Ottawa, 451 Smyth Rd (room 1020G), Ottawa, ON, K1H 8M5, Canada.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Sikora
authors.affiliation: Newfoundland and Labrador Centre for Health Information, 70 O'Leary Avenue St. John's, NL A1B 2C7, Canada.
authors.forename: Sonya
authors.initials: S
authors.lastname: Bowen
authors.affiliation: Newfoundland and Labrador Centre for Health Information, 70 O'Leary Avenue St. John's, NL A1B 2C7, Canada.
authors.forename: Kayla
authors.initials: K
authors.lastname: Collins
authors.affiliation: Newfoundland and Labrador Centre for Health Information, 70 O'Leary Avenue St. John's, NL A1B 2C7, Canada.
authors.forename: Don
authors.initials: D
authors.lastname: MacDonald
mesh_terms: D002170:Canada; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D018450:Disease Progression; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D008423:Maternal Age; D064887:Observational Studies as Topic; D017063:Outcome Assessment, Health Care; D012307:Risk Factors
keywords: Etiology; Hydrocephalus; Onset; Progression; Risk factors; Systematic review