Published online June 22, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. e554-e561 (doi:10.1542/peds.2006-1308)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ehrenstein, V. Articles by Sørensen, H. T. Search for Related Content PubMed Articles by Ehrenstein, V. Articles by Sørensen, H. T. Related Collections Neurology & Psychiatry Social Bookmarking                         What's this?

ARTICLE

Postterm Delivery and Risk for Epilepsy in Childhood

Vera Ehrenstein, MPH^a,b, Lars Pedersen, MSc^b, Vibeke Holsteen, MD^c, Helle Larsen, MD^d, Kenneth J. Rothman, DrPH^a and Henrik T. Sørensen, MD, PhD^a,b

^a Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
^b Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
^c Departments of Paediatrics
^d Gynaecology and Obstetrics, Aalborg Hospital, Aalborg, Denmark

OBJECTIVE. Postterm delivery is a risk factor for perinatal complications, some of which increase risk for neurologic morbidity. We aimed to examine the association between postterm delivery and risk for epilepsy in childhood.

METHODS. We conducted a cohort study of singleton children who were born in 3 Danish counties from 1980 to 2001. Birth registry data were linked with hospital records to identify cases of epilepsy in the first 12 years of life. We included children who were born at 39 gestational weeks and computed crude, age-specific, and birth weight standardized incidence rates of epilepsy. We estimated adjusted incidence rate ratios according to mode of delivery by Poisson regression.

RESULTS. Among the 277435 nonpreterm births, 32557 were at 42 weeks, including 3396 at 43 weeks. Nearly one fourth of the 2805 epilepsy cases occurred in the first year of life. In that period, birth weight standardized incidence rate ratios for epilepsy were 1.3 for birth at 42 weeks and 2.0 for birth at 43 weeks, compared with birth at 39 to 41 weeks. Among children who were delivered by cesarean section, incidence rate ratios adjusted for birth weight, presentation, malformations, and county were 1.4 for birth at 42 completed weeks and 4.9 for birth at 43 weeks, compared with term vaginal births. There was a similar tendency among children who were delivered with the assistance of instruments. We found no evidence for the association between postterm delivery and risk for epilepsy beyond the first year of life.

CONCLUSIONS. Prolonged gestation is a risk factor for early epilepsy; the added increase in risk for instrument-assisted and cesarean deliveries could be attributable to factors that are related to both birth complications and epilepsy.

---

Key Words: epidemiology • postterm delivery • epilepsy • prolonged pregnancy • child

Abbreviations: LMP—last menstrual period • CNS—central nervous system • ICD—International Classification of Diseases • CI—confidence interval • IRR—incidence rate ratio

---

Accepted Sep 20, 2006.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Y. Sun, M. Vestergaard, C. B. Pedersen, J. Christensen, O. Basso, and J. Olsen Gestational Age, Birth Weight, Intrauterine Growth, and the Risk of Epilepsy Am. J. Epidemiol., February 1, 2008; 167(3): 262 - 270. [Abstract] [Full Text] [PDF]