{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T21:13:28Z","timestamp":1780953208148,"version":"3.54.1"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Brain Research Program","award":["2017-2-1-NKP-2017-00002"],"award-info":[{"award-number":["2017-2-1-NKP-2017-00002"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nObjectives<\/jats:title>\nComprehensive statistics evaluating pregnancies complicated by various medical conditions are desirable for the optimization of prenatal care and for improving maternal and fetal outcomes. The main objective of our study was to assess pregnancies during a 13-year study period with accompanying pregestational neurological disorders in medical history on a nationwide level.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nIn the framework of the NEUROHUN 2004\u20132017 project utilizing medical reports submitted for reimbursement purposes to the National Health Insurance Fund, we included women with at least one labor during 2004\u20132016 who had at least one pregestational diagnosis of a neurological disorder received within this time frame prior to their first pregnancy during the studied period. Three-digit codes from the 10th<\/jats:sup> International Classification of Diseases (ICD) were used for the identification and classification of neurological and obstetrical conditions.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nSpecific inclusion and exclusion criteria were employed during the study process. A total of 744 226 women have been identified with at least one delivery during the study period with 98 792 of them (13.3%) having at least one neurological diagnosis received during 2004\u20132016 before their first gestation in the time frame of the study. The vast majority of diagnosis codes were related to different types of headaches affecting 69 149 (9.3%) individuals. The most prevalent diagnoses following headaches were dizziness and giddiness (15 589 patients [2.1%]; nerve, nerve root and plexus disorders (10 375 patients [1.4%]); epileptic disorders (7028 patients [0.9%]); neurological diseases of vascular origin (6091 patients [0.8%]); other disorders of the nervous system (5358 patients [0.7%]); and demyelinating diseases of the central nervous system (2129 patients [0.3%]). The present findings of our study show high prevalence of pregestational neurological disorders, the dominance of headaches followed by the rather nonspecific diagnosis of dizziness and giddiness, the relevance of nerve, nerve root and plexus disorders and epilepsy, and the importance of cerebrovascular disorders among women of childbearing age.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe present research findings can help healthcare professionals, researchers and decision makers in adopting specific health policy measures based on nationwide data and further aid the development of new diagnostic and therapeutic algorithms of various neurological manifestations concerning women of childbearing age.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0274873","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T17:30:45Z","timestamp":1663781445000},"page":"e0274873","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pregestational neurological disorders among women of childbearing age\u2014Nationwide data from a 13-year period in Hungary"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-0830","authenticated-orcid":true,"given":"D\u00e1niel","family":"Bereczki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nika","family":"B\u00e1lint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Ajtay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferenc","family":"Oberfrank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ildik\u00f3","family":"Vastagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,21]]},"reference":[{"key":"pone.0274873.ref001","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1556\/650.2016.30421","article-title":"Terhess\u00e9g \u00e9s akut ischaemi\u00e1s stroke [Pregnancy and acute ischemic stroke]","volume":"157","author":"D Bereczki","year":"2016","journal-title":"Orv Hetil"},{"key":"pone.0274873.ref002","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1046\/j.1468-2982.2000.00112.x","article-title":"Migraine with aura and reproductive life events: a case control study","volume":"20","author":"F Granella","year":"2000","journal-title":"Cephalalgia"},{"key":"pone.0274873.ref003","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1007\/s13311-017-0562-7","article-title":"Pregnancy: effect on multiple sclerosis, treatment considerations, and breastfeeding","volume":"14","author":"R Voskuhl","year":"2017","journal-title":"Neurotherapeutics"},{"key":"pone.0274873.ref004","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.nmd.2017.01.021","article-title":"Clinical follow-up of pregnancy in myasthenia gravis patients","volume":"27","author":"RD Ducci","year":"2017","journal-title":"Neuromuscul Disord"},{"key":"pone.0274873.ref005","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1212\/01.wnl.0000195888.51845.80","article-title":"Seizure control and treatment in pregnancy. Observations from the EURAP epilepsy pregnancy registry","volume":"66","author":"The EURAP Study Group","year":"2006","journal-title":"Neurology"},{"key":"pone.0274873.ref006","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ncl.2018.09.010","article-title":"Stroke in pregnancy: an update","volume":"37","author":"EC Camargo","year":"2019","journal-title":"Neurol Clin"},{"key":"pone.0274873.ref007","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.ncl.2018.01.005","article-title":"An update: myasthenia gravis and pregnancy","volume":"36","author":"J Hamel","year":"2018","journal-title":"Neurol Clin"},{"key":"pone.0274873.ref008","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/aogs.13109","article-title":"Women treated for epilepsy during pregnancy: outcomes from a nationwide population-based cohort study","volume":"96","author":"M Artama","year":"2017","journal-title":"Acta Obstet Gynecol Scand"},{"key":"pone.0274873.ref009","first-page":"1064","article-title":"Obstructive sleep apnea: women\u2019s perspective","volume":"3","author":"S Jehan","year":"2016","journal-title":"J Sleep Med Disord"},{"key":"pone.0274873.ref010","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/head.13023","article-title":"Delivery outcomes of patients with acute migraine in pregnancy: a retrospective study","volume":"57","author":"TB Grossman","year":"2017","journal-title":"Headache"},{"key":"pone.0274873.ref011","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1161\/STROKEAHA.117.019904","article-title":"Increased risk of pregnancy complications after stroke: the FUTURE study (Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation)","volume":"49","author":"ME van Alebeek","year":"2018","journal-title":"Stroke"},{"key":"pone.0274873.ref012","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/epi.13632","article-title":"Malformation risk of antiepileptic drug exposure during pregnancy in women with epilepsy: results from a pregnancy registry in South India","volume":"58","author":"SV Thomas","year":"2017","journal-title":"Epilepsia"},{"key":"pone.0274873.ref013","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.ncl.2016.04.009","article-title":"Neurology of pregnancy: a case-oriented review","volume":"34","author":"MA O\u2019Neal","year":"2016","journal-title":"Neurol Clin"},{"key":"pone.0274873.ref014","first-page":"773","article-title":"Pregnancy and family planning in multiple sclerosis","volume":"25","author":"AM Langer-Gould","year":"2019","journal-title":"Continuum (Minneap Minn)"},{"key":"pone.0274873.ref015","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/ene.13645","article-title":"Demand for neurological services in Central Eastern Europe: a 10-year national survey in Hungary","volume":"25","author":"F Oberfrank","year":"2018","journal-title":"Eur J Neurol"},{"key":"pone.0274873.ref016","unstructured":"International Statistical Classification of Diseases and Related Health Problems 10th Revision (Version: 2016). [Cited 2021 February 23]. In: World Health Organization Homepage [Internet]. https:\/\/icd.who.int\/browse10\/2016\/en"},{"key":"pone.0274873.ref017","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1556\/650.2015.30258","article-title":"A k\u00f3rh\u00e1zi adatlapok jelent\u00e9seinek alkalmazhat\u00f3s\u00e1ga epidemiol\u00f3giai elemz\u00e9sekre az ischaemi\u00e1s cerebrovascularis betegs\u00e9gek p\u00e9ld\u00e1ja alapj\u00e1n [Applicability of hospital reports submitted for reimbursement purposes for epidemiological studies based on the example of ischemic cerebrovascular diseases]","volume":"156","author":"A. Ajtay","year":"2015","journal-title":"Orv Hetil"},{"issue":"Suppl 2","key":"pone.0274873.ref018","first-page":"778","article-title":"Headache in Hungarian neurology outpatient services","volume":"23","author":"M Magyar","year":"2016","journal-title":"Eur J Neurol"},{"key":"pone.0274873.ref019","doi-asserted-by":"crossref","first-page":"640","DOI":"10.3389\/fneur.2019.00640","article-title":"Linking individual patient data to estimate incidence and prevalence of Parkinson\u2019s disease by comparing reports of neurological services and pharmacy prescription refills at a nationwide level","volume":"10","author":"S Szatm\u00e1ri","year":"2019","journal-title":"Front Neurol"},{"key":"pone.0274873.ref020","doi-asserted-by":"crossref","first-page":"e0236728","DOI":"10.1371\/journal.pone.0236728","article-title":"The prevalence of psychiatric symptoms before the diagnosis of Parkinson\u2019s disease in a nationwide cohort: a comparison to patients with cerebral infarction","volume":"15","author":"S Szatm\u00e1ri","year":"2020","journal-title":"PLoS One"},{"key":"pone.0274873.ref021","doi-asserted-by":"crossref","first-page":"e0236432","DOI":"10.1371\/journal.pone.0236432","article-title":"Incidence and prevalence of multiple sclerosis in Hungary based on record linkage of nationwide multiple healthcare administrative data","volume":"15","author":"A Iljicsov","year":"2020","journal-title":"PLoS One"},{"key":"pone.0274873.ref022","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, regional, and national incidence, prevalence and years lived with disability for 328 diseases and injuries for 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"T Vos","year":"2017","journal-title":"Lancet"},{"key":"pone.0274873.ref023","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/S1474-4422(18)30322-3","article-title":"Global, regional, and national burden of migraine and tension-type headache, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"17","author":"LJ Stovner","year":"2018","journal-title":"Lancet Neurol"},{"key":"pone.0274873.ref024","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s10194-020-01208-0","article-title":"Migraine remains second among the world\u2019s causes of disability, and first among young women: findings from GBD2019","volume":"21","author":"TJ Steiner","year":"2020","journal-title":"J Headache Pain"},{"key":"pone.0274873.ref025","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1468-2982.2007.01288.x","article-title":"The global burden of headache: a documentation of headache prevalence and disability worldwide","volume":"27","author":"LJ Stovner","year":"2007","journal-title":"Cephalalgia"},{"key":"pone.0274873.ref026","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/0002-9343(89)90293-3","article-title":"Common symptoms in ambulatory case: incidence, evaluation, therapy, and outcome","volume":"86","author":"K Kroenke","year":"1989","journal-title":"Am J Med"},{"key":"pone.0274873.ref027","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/B978-0-444-63437-5.00005-4","article-title":"The epidemiology of dizziness and vertigo","volume":"137","author":"HK Neuhauser","year":"2016","journal-title":"Handb Clin Neurol"},{"key":"pone.0274873.ref028","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12875-017-0695-0","article-title":"Prevalence, aetiologies and prognosis of the symptom dizziness in primary care\u2013a systematic review","volume":"19","author":"S B\u00f6sner","year":"2018","journal-title":"BMC Fam Pract"},{"key":"pone.0274873.ref029","doi-asserted-by":"crossref","first-page":"765","DOI":"10.4065\/83.7.765","article-title":"Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample","volume":"83","author":"DE Newman-Toker","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"pone.0274873.ref030","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.mcna.2018.10.012","article-title":"Entrapment neuropathies of the upper extremity","volume":"103","author":"CT Doughty","year":"2019","journal-title":"Med Clin North Am"},{"key":"pone.0274873.ref031","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1212\/WNL.38.1.134","article-title":"Carpal tunnel syndrome in Rochester, Minnesota, 1961 to 1980","volume":"38","author":"JC Stevens","year":"1988","journal-title":"Neurology"},{"key":"pone.0274873.ref032","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/B978-0-444-64142-7.00049-7","article-title":"Upper extremity neuropathies","volume":"161","author":"JC Kincaid","year":"2019","journal-title":"Handb Clin Neurol"},{"key":"pone.0274873.ref033","doi-asserted-by":"crossref","first-page":"e020166","DOI":"10.1136\/bmjopen-2017-020166","article-title":"Trends in the prevalence, incidence and surgical management of carpal tunnel syndrome between 1993 and 2013: an observational analysis of UK primary care records","volume":"8","author":"CL Burton","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0274873.ref034","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1034\/j.1600-0528.2002.300108.x","article-title":"Oro-facial pain in the community: prevalence and associated impact","volume":"30","author":"TV Macfarlene","year":"2002","journal-title":"Community Dent Oral Epidemiol"},{"key":"pone.0274873.ref035","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s11916-017-0609-9","article-title":"Atypical facial pain: a comprehensive evidence-based review","volume":"21","author":"AL Weiss","year":"2017","journal-title":"Curr Pain Headache Rep"},{"key":"pone.0274873.ref036","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.adaj.2016.02.014","article-title":"Prevalence of trigeminal neuralgia: a systematic review","volume":"147","author":"IP De Toledo","year":"2016","journal-title":"J Am Dent Assoc"},{"key":"pone.0274873.ref037","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1097\/WCO.0000000000000622","article-title":"Multiple sclerosis: clinical aspects","volume":"31","author":"J Oh","year":"2018","journal-title":"Curr Opin Neurol"},{"key":"pone.0274873.ref038","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.msard.2019.06.015","article-title":"Trigeminal neuralgia: comparison of characteristics and impact in patients with or without multiple sclerosis","volume":"34","author":"K Godazandeh","year":"2019","journal-title":"Mult Scler Relat Disord"},{"issue":"Suppl 6","key":"pone.0274873.ref039","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1007\/s00586-017-5432-9","article-title":"The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies","volume":"27","author":"EL Hurwitz","year":"2018","journal-title":"Eur Spine J"},{"key":"pone.0274873.ref040","first-page":"49","article-title":"Global, regional and national burden of low back pain 1990\u20132019: a systematic analysis of the Global Burden of Disease study 2019","volume":"32","author":"S Chen","year":"2021","journal-title":"J Ortop Translat"},{"key":"pone.0274873.ref041","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/000164802760370736","article-title":"Bell\u2019s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies","volume":"549","author":"E. Peitersen","year":"2002","journal-title":"Acta Otolaryngol Suppl"},{"key":"pone.0274873.ref042","doi-asserted-by":"crossref","first-page":"e00492","DOI":"10.1002\/brb3.492","article-title":"Age-specific birth rates in women with epilepsy: a population-based study","volume":"6","author":"AH Farmen","year":"2016","journal-title":"Brain Behav"},{"key":"pone.0274873.ref043","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1001\/jamaneurol.2018.0646","article-title":"Fertility and birth outcomes in women with epilepsy seeking pregnancy","volume":"75","author":"PB Pennell","year":"2018","journal-title":"JAMA Neurol"},{"key":"pone.0274873.ref044","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1136\/postgradmedj-2016-134191","article-title":"Update on management of epilepsy in women for the non-neurologist","volume":"92","author":"IK Gooneratne","year":"2016","journal-title":"Postgrad Med J"},{"key":"pone.0274873.ref045","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1468-1331.2006.01138.x","article-title":"Stroke incidence and prevalence in Europe: a review of available data","volume":"13","author":"T Truelsen","year":"2006","journal-title":"Eur J Neurol"},{"key":"pone.0274873.ref046","doi-asserted-by":"crossref","first-page":"I","DOI":"10.1177\/23969873221078696","article-title":"European Stroke Organisation guidelines on stroke in women: Management of menopause, pregnancy and postpartum","volume":"7","author":"C Kremer","year":"2022","journal-title":"Eur Stroke J"},{"key":"pone.0274873.ref047","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.mcna.2011.11.003","article-title":"Age as a cardiovascular risk factor","volume":"96","author":"R Dhingra","year":"2012","journal-title":"Med Clin North Am"},{"key":"pone.0274873.ref048","first-page":"1","article-title":"Births in the United States, 2016","volume":"287","author":"JA Martin","year":"2017","journal-title":"NCHS Data Brief"},{"key":"pone.0274873.ref049","unstructured":"Statistical Bulletin: Live Births in England and Wales by Characteristics of Mother 1: 2013. [Cited 2021 February 23]. In: Office for National Statistics Homepage [Internet]. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/livebirths\/bulletins\/livebirthsinenglandandwalesbycharacteristicsofmother1\/2014-10-16"},{"key":"pone.0274873.ref050","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/ane.12219","article-title":"Prevalence of multiple sclerosis in Csongr\u00e1d County, Hungary","volume":"130","author":"V Zsiros","year":"2014","journal-title":"Acta Neurol Scand"},{"key":"pone.0274873.ref051","doi-asserted-by":"crossref","first-page":"e01598","DOI":"10.1002\/brb3.1598","article-title":"Epidemiology of multiple sclerosis in Central Europe, update from Hungary","volume":"10","author":"T Biernacki","year":"2020","journal-title":"Brain Behav"},{"key":"pone.0274873.ref052","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1186\/1472-6963-14-381","article-title":"Multiple sclerosis in Germany: data analysis of administrative prevalence and healthcare delivery in the statutory health system","volume":"14","author":"A H\u00f6er","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"pone.0274873.ref053","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/978-3-319-47861-6_9","article-title":"Multiple sclerosis epidemiology in Europe","volume":"958","author":"D Bezzini","year":"2017","journal-title":"Adv Exp Med Biol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0274873","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T17:31:51Z","timestamp":1663781511000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0274873"}},"subtitle":[],"editor":[{"given":"Emily W.","family":"Harville","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,21]]},"references-count":53,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0274873","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,21]]}}}