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Published online May 1, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1100-e1107 (doi:10.1542/peds.2007-2316)
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ARTICLE

Prenatal Exposure to Maternal Infections and Epilepsy in Childhood: A Population-Based Cohort Study

Yuelian Sun, MDa,b, Mogens Vestergaard, MD, PhDa,c, Jakob Christensen, MD, PhDd, André J. Nahmias, MPHe, Jørn Olsen, MD, PhDa,f

a Departments of aEpidemiology
c General Practice, Institute of Public Health, University of Aarhus, Aarhus, Denmark
b Shanghai Institute of Planned Parenthood Research, Shanghai, China
d Department of Neurology and Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
e Pediatric Infectious Diseases, Epidemiology and Immunology, Emory University, Atlanta, Georgia
f Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, California

OBJECTIVE. We estimated the association between prenatal exposure to maternal infections and the subsequent risk for epilepsy in childhood.

METHODS. We included 90619 singletons who were born between September 1997 and June 2003 in the Danish National Birth Cohort and followed them up to December 2005. Information on maternal infections during pregnancy (cystitis, pyelonephritis, diarrhea, coughs lasting >1 week, vaginal yeast infection, genital herpes, venereal warts, and herpes labialis) was prospectively reported by mothers in 2 computer-assisted telephone interviews in early and midgestation; information on maternal cystitis and pyelonephritis during late period of pregnancy was also collected in a third interview after birth. Children who received a diagnosis of epilepsy as inpatients or outpatients were retrieved from the Danish National Hospital Register. We identified 646 children with a diagnosis of epilepsy during up to 8 years of follow-up time. Cox proportional hazards regression models were used to estimate incidence rate ratio and 95% confidence interval.

RESULTS. Children who were exposed to maternal cystitis, pyelonephritis, diarrhea, coughs, and/or vaginal yeast infection some maternal infections in prenatal life had an increased risk for epilepsy. Coughs lasting >1 week were associated with an increased risk for epilepsy only in the first year of life, as was vaginal yeast infection only in children who were born preterm. These associations remained unchanged for children without cerebral palsy, congenital malformation, or a low Apgar score at 5 minutes.

CONCLUSIONS. Prenatal exposure to some maternal infections was associated with an increased risk for epilepsy in childhood.

Key Words: epilepsy • infection • prenatal • pregnancy • cohort studies • etiology

Abbreviations: DNBC—Danish National Birth Cohort • ICD-10—International Classification of Diseases, 10th Revision • IRR—incidence rate ratio • CI—confidence interval

Accepted Oct 12, 2007.


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Risk factors for epilepsy in childhood: Maternal symptoms and infections
Ahmet Sert
Pediatrics Online, 2 Jun 2008 [Full text]