Factors associated with brain and pre-brain arteriovenous malformation: a case control study

Abstract

Introduction. Brain and pre-brain arteriovenous malformations (BAVMs) are an important cause of hemorrhagic stroke among youth, although are normally a congenital condition, can easily pass unnoticed for years. Objective. To find predictors of BAVMs. Method. Case control study based in the database of the Health Information System (TABNET), made available by the Informatics Department of the Brazilian National Health System (DATASUS). Information of children born with BAVMs (ICD Q280 and Q282) ranging from 2010 to 2020 was collected and compared with all the other childrens born at the same period of time. Results. A total of 75 cases of BAVMs were found, with 21 being pre-cerebral and 54 cerebral. Females represented 55% (41) of the patients. A cohort of 40,588,143 babies was used as control. Preterm newborns had an approximate 10 times higher chance of having BAVMs (p<0.001; OR:9.990; CI: 6.347-15.725). Cesarean birth was associated with 63% higher chance of BAVMs.(p<0.001; OR: 0.372; CI: 0.219-0.632). Ethnicity was also associated with BAVMs, notably with white ones having 2,2 times more chances of having BAVM (p=0.001; OR: 2.242; CI:1.379-3.643). Twin pregnancy was marginally associated with BAVMs (p=0.063; OR: 0.361; CI: 0.132-0.989). Conclusion. Prematurity, cesarean birth, and white ethnicity were significantly associated with BAVMs. These findings are worth considering to guide screening strategies and clinical suspicion. Prospective cohort studies in the same topic are recommended.