Timo Koivisto

Background and objectives There is emerging evidence on the connection between pre‐eclampsia and saccular intracranial aneurysms (sIAs). Our aim was to study the prevalence of pre‐eclampsia in sIA patients, their female relatives, and matched controls, and to examine familial sIA disease and familial pre‐eclampsia in sIA patients' families. Methods We included all female sIA patients in the Kuopio Intracranial Aneurysm Patient and Family Database from 1995 to 2018. First, we identified the sIA patients, their female relatives, and matched population controls with the first birth in 1987 or later and studied the prevalence of pre‐eclampsia. Second, all female sIA patients and all female relatives were analyzed for familial sIA disease and familial pre‐eclampsia. Using the Finnish nationwide health registries, we obtained data on drug purchases, hospital diagnoses, and causes of death. Results In total, 265 sIA patients, 57 daughters, 167 sisters, 169 nieces, and 546 matched controls had the first birth in 1987 or later. Among them, 29 (11%) sIA patients, 5 (9%) daughters, 10 (6%) sisters, 10 (6%) nieces, and 32 (6%) controls had pre‐eclampsia. Of all the 1895 female sIA patients and 12,141 female relatives, 68 sIA patients and 375 relatives had pre‐eclampsia, including 32 families with familial pre‐eclampsia. Conclusions Pre‐eclampsia was significantly more common in the sIA patients than in their matched controls. Familial sIA disease and familial pre‐eclampsia co‐occurred in seven families. Further studies of the mechanisms by which pre‐eclampsia could affect the walls of brain arteries and increase the rupture risk in sIA disease are indicated.