{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:35:52Z","timestamp":1792276552798,"version":"4.4.0"},"reference-count":60,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,11]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Congenital hydrocephalus (CH) is one of the most frequent CNS congenital malformations, representing an entity with serious pathological consequences. Although several studies have previously assessed child-related risk factors associated with CH development, there is a gap of knowledge on maternal environmental risk factors related to CH. The authors have systematically assessed extrinsic factors in the maternal environment that potentially confer an increased risk of CH development.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The Cochrane Library, MEDLINE, and EMBASE were systematically searched for works published between 1966 and December 2015 to identify all relevant articles published in English. Only studies that investigated environmental risk factors concerning the mother\u2014either during gestation or pregestationally\u2014were included.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In total, 13 studies (5 cohorts, 3 case series, 3 case-control studies, 1 meta-analysis, and 1 case report) meeting the inclusion criteria were identified. Maternal medication or alcohol use during gestation; lifestyle modifiable maternal pathologies such as obesity, diabetes, or hypertension; lack of prenatal care; and a low socioeconomic status were identified as significant maternal environmental risk factors for CH development. Maternal infections and trauma to the mother during pregnancy have also been highlighted as potential mother-related risk factors for CH.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Congenital hydrocephalus is an important cause of serious infant health disability that can lead to health inequalities among adults. The present study identified several maternal environmental risk factors for CH, thus yielding important scientific information relevant to prevention of some CH cases. However, further research is warranted to confirm the impact of the identified factors and examine their underlying behavioral and\/or biological basis, leading to the generation of suitable prevention strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.8.focus16280","type":"journal-article","created":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T03:38:03Z","timestamp":1477971483000},"page":"E3","source":"Crossref","is-referenced-by-count":25,"title":["Maternal environmental risk factors for congenital hydrocephalus: a systematic review"],"prefix":"10.3171","volume":"41","author":[{"given":"Aristotelis V.","family":"Kalyvas","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Evangelismos Hospital, University of Athens;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodosis","family":"Kalamatianos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Evangelismos Hospital, University of Athens;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mantha","family":"Pantazi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, General Hospital of Ioannina \u201cG. Hatzikosta\u201d; and\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios D.","family":"Lianos","sequence":"additional","affiliation":[{"name":"Departments of Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Stranjalis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Evangelismos Hospital, University of Athens;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Alexiou","sequence":"additional","affiliation":[{"name":"Neurosurgery, University Hospital of Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16280","series-title":"Childs Brain","first-page":"325","article-title":"Experimental congenital hydrocephalus. A review with special consideration of hydrocephalus produced by zinc deficiency","volume":"2","author":"Adeloye","year":"1976"},{"key":"b2-focus16280","series-title":"CNS Drugs","first-page":"499","article-title":"Safety of selective serotonin reuptake inhibitors in pregnancy: a review of current evidence","volume":"30","author":"Alwan","year":"2016"},{"key":"b3-focus16280","series-title":"CNS Spectr","first-page":"39","article-title":"Antidepressant medication use, depression, and the risk of preeclampsia","volume":"20","author":"Avalos","year":"2015"},{"key":"b4-focus16280","series-title":"Fetal Medicine: Basic Science and Clinical Practice","first-page":"620","article-title":"Fetal infection","author":"Benoist","year":"2009"},{"key":"b5-focus16280","series-title":"Teratology","first-page":"326","article-title":"Timing of prenatal care initiation and risk of congenital malformations","volume":"66","author":"Carmichael","year":"2002"},{"key":"b6-focus16280","series-title":"Clin Infect Dis","first-page":"509","article-title":"Congenital enterovirus 71 infection: a case study with virology and immunohistochemistry","volume":"31","author":"Chow","year":"2000"},{"key":"b7-focus16280","series-title":"J Pediatr","first-page":"64","article-title":"Brain malformations related to prenatal exposure to ethanol","volume":"92","author":"Clarren","year":"1978"},{"key":"b8-focus16280","series-title":"Br J Obstet Gynaecol","first-page":"322","article-title":"A population based case-control teratologic study of oral metronidazole treatment during pregnancy","volume":"105","author":"Czeizel","year":"1998"},{"key":"b9-focus16280","series-title":"Br J Clin Pharmacol","first-page":"362","article-title":"Antidepressant use during pregnancy and the risk of pregnancy-induced hypertension","volume":"74","author":"De Vera","year":"2012"},{"key":"b10-focus16280","series-title":"Teratog Carcinog Mutagen","first-page":"377","article-title":"Relationship of periventricular overgrowth to hydrocephalus in brains of fetal rats exposed to benomyl","volume":"8","author":"Ellis","year":"1988"},{"key":"b11-focus16280","series-title":"J Obstet Gynaecol Can","first-page":"680","article-title":"Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis","volume":"28","author":"Goh","year":"2006"},{"key":"b12-focus16280","series-title":"Clin Infect Dis","first-page":"1831","article-title":"Patterns of hydrocephalus caused by congenital Toxoplasma gondii infection associate with parasite genetics","volume":"61","author":"Hutson","year":"2015"},{"key":"b13-focus16280","series-title":"Birth Defects Res A Clin Mol Teratol","first-page":"187","article-title":"Teratogen update: methotrexate","volume":"94","author":"Hyoun","year":"2012"},{"key":"b14-focus16280","series-title":"Pediatr Neurol","first-page":"67","article-title":"Prevalence of congenital hydrocephalus in California, 1991\u20132000","volume":"45","author":"Jeng","year":"2011"},{"key":"b15-focus16280","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"174","article-title":"Teratogenic potential of vaginal metronidazole treatment during pregnancy","volume":"123","author":"Kazy","year":"2005"},{"key":"b16-focus16280","series-title":"Reprod Toxicol","first-page":"464","article-title":"Teratogenic potential of tribenoside, a drug for the treatment of haemorrhoids and varicose veins\u2014a population-based case\u2013control study","volume":"31","author":"Kubicsek","year":"2011"},{"key":"b17-focus16280","series-title":"Int J Neurosci","first-page":"338","article-title":"MRI findings of neurological complications in hand-foot-mouth disease by enterovirus 71 infection","volume":"122","author":"Li","year":"2012"},{"key":"b18-focus16280","series-title":"BMJ","first-page":"b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.","volume":"339","author":"Moher","year":"2009"},{"key":"b19-focus16280","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1253","article-title":"Risk factors for congenital hydrocephalus: a nationwide, register-based, cohort study","volume":"85","author":"Munch","year":"2014"},{"key":"b20-focus16280","series-title":"Prog Neuropsychopharmacol Biol Psychiatry","first-page":"1400","article-title":"The age-dependent effects of selective serotonin reuptake inhibitors in humans and rodents: A review","volume":"35","author":"Olivier","year":"2011"},{"key":"b21-focus16280","series-title":"Int J Epidemiol","first-page":"891","article-title":"Nitrosatable drug exposure during pregnancy and adverse pregnancy outcome","volume":"18","author":"Olshan","year":"1989"},{"key":"b22-focus16280","series-title":"Cerebrospinal Fluid Res","first-page":"2","article-title":"The definition and classification of hydrocephalus: a personal recommendation to stimulate debate.","volume":"5","author":"Rekate","year":"2008"},{"key":"b23-focus16280","series-title":"Birth Defects Res A Clin Mol Teratol","first-page":"431","article-title":"A pilot study using residual newborn dried blood spots to assess the potential role of cytomegalovirus and Toxoplasma gondii in the etiology of congenital hydrocephalus","volume":"97","author":"Simeone","year":"2013"},{"key":"b24-focus16280","series-title":"JAMA","first-page":"636","article-title":"Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis","volume":"301","author":"Stothard","year":"2009"},{"key":"b25-focus16280","series-title":"Pediatrics","first-page":"232","article-title":"Magnetic resonance imaging of brain anomalies in fetal alcohol syndrome","volume":"99","author":"Swayze","year":"1997"},{"key":"b26-focus16280","series-title":"Eur J Med Genet","first-page":"359","article-title":"Infantile hydrocephalus: a review of epidemiology, classification and causes","volume":"57","author":"Tully","year":"2014"},{"key":"b27-focus16280","series-title":"J Neurol Neurosurg Psychiatry","first-page":"213","article-title":"Risk factors of congenital hydrocephalus: a 10 year retrospective study","volume":"80","author":"Van Landingham","year":"2009"},{"key":"b28-focus16280","series-title":"Neurotoxicology","article-title":"A systematic review of the risks factors associated with the onset and natural progression of hydrocephalus.","author":"Walsh","year":"2016"},{"key":"b29-focus16280","series-title":"Pediatrics","first-page":"E9","article-title":"Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or Cytomegalovirus infection.","volume":"100","author":"Wright","year":"1997"},{"key":"b30-focus16280","series-title":"Neurol Med Chir (Tokyo)","first-page":"326","article-title":"Congenital hydrocephalus mimicking Dandy-Walker syndrome induced by 6-aminonicotinamide injection in pregnant rat","volume":"31","author":"Yamada","year":"1991"},{"key":"b1-focus16280","series-title":"Childs Brain","first-page":"325","article-title":"Experimental congenital hydrocephalus. A review with special consideration of hydrocephalus produced by zinc deficiency","volume":"2","author":"Adeloye","year":"1976"},{"key":"b2-focus16280","series-title":"CNS Drugs","first-page":"499","article-title":"Safety of selective serotonin reuptake inhibitors in pregnancy: a review of current evidence","volume":"30","author":"Alwan","year":"2016"},{"key":"b3-focus16280","series-title":"CNS Spectr","first-page":"39","article-title":"Antidepressant medication use, depression, and the risk of preeclampsia","volume":"20","author":"Avalos","year":"2015"},{"key":"b4-focus16280","series-title":"Fetal Medicine: Basic Science and Clinical Practice","first-page":"620","article-title":"Fetal infection","author":"Benoist","year":"2009"},{"key":"b5-focus16280","series-title":"Teratology","first-page":"326","article-title":"Timing of prenatal care initiation and risk of congenital malformations","volume":"66","author":"Carmichael","year":"2002"},{"key":"b6-focus16280","series-title":"Clin Infect Dis","first-page":"509","article-title":"Congenital enterovirus 71 infection: a case study with virology and immunohistochemistry","volume":"31","author":"Chow","year":"2000"},{"key":"b7-focus16280","series-title":"J Pediatr","first-page":"64","article-title":"Brain malformations related to prenatal exposure to ethanol","volume":"92","author":"Clarren","year":"1978"},{"key":"b8-focus16280","series-title":"Br J Obstet Gynaecol","first-page":"322","article-title":"A population based case-control teratologic study of oral metronidazole treatment during pregnancy","volume":"105","author":"Czeizel","year":"1998"},{"key":"b9-focus16280","series-title":"Br J Clin Pharmacol","first-page":"362","article-title":"Antidepressant use during pregnancy and the risk of pregnancy-induced hypertension","volume":"74","author":"De Vera","year":"2012"},{"key":"b10-focus16280","series-title":"Teratog Carcinog Mutagen","first-page":"377","article-title":"Relationship of periventricular overgrowth to hydrocephalus in brains of fetal rats exposed to benomyl","volume":"8","author":"Ellis","year":"1988"},{"key":"b11-focus16280","series-title":"J Obstet Gynaecol Can","first-page":"680","article-title":"Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis","volume":"28","author":"Goh","year":"2006"},{"key":"b12-focus16280","series-title":"Clin Infect Dis","first-page":"1831","article-title":"Patterns of hydrocephalus caused by congenital Toxoplasma gondii infection associate with parasite genetics","volume":"61","author":"Hutson","year":"2015"},{"key":"b13-focus16280","series-title":"Birth Defects Res A Clin Mol Teratol","first-page":"187","article-title":"Teratogen update: methotrexate","volume":"94","author":"Hyoun","year":"2012"},{"key":"b14-focus16280","series-title":"Pediatr Neurol","first-page":"67","article-title":"Prevalence of congenital hydrocephalus in California, 1991\u20132000","volume":"45","author":"Jeng","year":"2011"},{"key":"b15-focus16280","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"174","article-title":"Teratogenic potential of vaginal metronidazole treatment during pregnancy","volume":"123","author":"Kazy","year":"2005"},{"key":"b16-focus16280","series-title":"Reprod Toxicol","first-page":"464","article-title":"Teratogenic potential of tribenoside, a drug for the treatment of haemorrhoids and varicose veins\u2014a population-based case\u2013control study","volume":"31","author":"Kubicsek","year":"2011"},{"key":"b17-focus16280","series-title":"Int J Neurosci","first-page":"338","article-title":"MRI findings of neurological complications in hand-foot-mouth disease by enterovirus 71 infection","volume":"122","author":"Li","year":"2012"},{"key":"b18-focus16280","series-title":"BMJ","first-page":"b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.","volume":"339","author":"Moher","year":"2009"},{"key":"b19-focus16280","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1253","article-title":"Risk factors for congenital hydrocephalus: a nationwide, register-based, cohort study","volume":"85","author":"Munch","year":"2014"},{"key":"b20-focus16280","series-title":"Prog Neuropsychopharmacol Biol Psychiatry","first-page":"1400","article-title":"The age-dependent effects of selective serotonin reuptake inhibitors in humans and rodents: A review","volume":"35","author":"Olivier","year":"2011"},{"key":"b21-focus16280","series-title":"Int J Epidemiol","first-page":"891","article-title":"Nitrosatable drug exposure during pregnancy and adverse pregnancy outcome","volume":"18","author":"Olshan","year":"1989"},{"key":"b22-focus16280","series-title":"Cerebrospinal Fluid Res","first-page":"2","article-title":"The definition and classification of hydrocephalus: a personal recommendation to stimulate debate.","volume":"5","author":"Rekate","year":"2008"},{"key":"b23-focus16280","series-title":"Birth Defects Res A Clin Mol Teratol","first-page":"431","article-title":"A pilot study using residual newborn dried blood spots to assess the potential role of cytomegalovirus and Toxoplasma gondii in the etiology of congenital hydrocephalus","volume":"97","author":"Simeone","year":"2013"},{"key":"b24-focus16280","series-title":"JAMA","first-page":"636","article-title":"Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis","volume":"301","author":"Stothard","year":"2009"},{"key":"b25-focus16280","series-title":"Pediatrics","first-page":"232","article-title":"Magnetic resonance imaging of brain anomalies in fetal alcohol syndrome","volume":"99","author":"Swayze","year":"1997"},{"key":"b26-focus16280","series-title":"Eur J Med Genet","first-page":"359","article-title":"Infantile hydrocephalus: a review of epidemiology, classification and causes","volume":"57","author":"Tully","year":"2014"},{"key":"b27-focus16280","series-title":"J Neurol Neurosurg Psychiatry","first-page":"213","article-title":"Risk factors of congenital hydrocephalus: a 10 year retrospective study","volume":"80","author":"Van Landingham","year":"2009"},{"key":"b28-focus16280","series-title":"Neurotoxicology","article-title":"A systematic review of the risks factors associated with the onset and natural progression of hydrocephalus.","author":"Walsh","year":"2016"},{"key":"b29-focus16280","series-title":"Pediatrics","first-page":"E9","article-title":"Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or Cytomegalovirus infection.","volume":"100","author":"Wright","year":"1997"},{"key":"b30-focus16280","series-title":"Neurol Med Chir (Tokyo)","first-page":"326","article-title":"Congenital hydrocephalus mimicking Dandy-Walker syndrome induced by 6-aminonicotinamide injection in pregnant rat","volume":"31","author":"Yamada","year":"1991"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/41\/5\/article-pE3.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/41\/5\/article-pE3.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/41\/5\/article-pE3.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T08:58:26Z","timestamp":1779526706000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/41\/5\/article-pE3.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11]]},"references-count":60,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2016.8.focus16280","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11]]}}}