Published online October 31, 2008
PEDIATRICS Vol. 122 No. 5 November 2008, pp. 1072-1078 (doi:10.1542/peds.2007-3666)

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ARTICLE

Preeclampsia and Risk for Epilepsy in Offspring

Chun Sen Wu, MD^a,b, Yuelian Sun, MD, PhD^a, Mogens Vestergaard, MD, PhD^a,c, Jakob Christensen, MD, PhD^d, Roberta B. Ness, MD, PhD^e, Catherine L. Haggerty, MD, PhD^e and Jørn Olsen, MD, PhD^a,f

Departments of ^a Epidemiology
^c General Practice, Institute of Public Health, University of Aarhus, Aarhus, Denmark
^b Center of Disease Prevention and Control of Jiexiu, Shanxi, China
^d Department of Neurology and Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark
^e Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
^f Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, California

OBJECTIVE. Eclampsia has been found to be a strong risk factor for epilepsy in the offspring, but it is unclear whether the risk also applies to the preceding condition, preeclampsia.

METHODS. We conducted a population-based cohort study of 1537860 singletons born in Denmark (1978–2004). Information on preeclampsia (mild, severe, and unspecified), eclampsia, and epilepsy was obtained from the Danish National Hospital Register. Information on gestational age, birth weight, and Apgar score was obtained from the Danish Medical Birth Registry. We used Cox proportional hazard models to estimate the incidence rate ratio of epilepsy for children who were exposed to preeclampsia or eclampsia in prenatal life.

RESULTS. We identified 45288 (2.9%) children who were exposed to preeclampsia (34823 to mild, 7043 to severe, and 3422 to unspecified preeclampsia) and 654 (0.04%) to eclampsia during their prenatal life. We identified 20260 people who received a diagnosis of epilepsy during up to 27 years of follow-up in the entire cohort. Prenatal exposure to preeclampsia was associated with an increased risk for epilepsy among children with a gestational age at birth of at least 37 weeks. For mild preeclampsia, the incidence rate ratios were 1.16 among children born at term and 1.68 for children born postterm; for severe preeclampsia, the incidence rate ratios were 1.41 among children born at term and 2.57 among children born postterm. No associations between preeclampsia and epilepsy were found among children who were born preterm. Eclampsia was associated with epilepsy with an incidence rate ratio of 1.29 for children born at term and 5.03 for children born postterm.

CONCLUSIONS. Prenatal exposure to both preeclampsia and eclampsia was associated with an increased risk of epilepsy in children born after 37 weeks of gestation.

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Key Words: eclampsia • epilepsy • pregnancy • preeclampsia • cohort studies

Abbreviations: ICD—International Classification of Diseases • SGA—small for gestational age • IRR—incidence rate ratio • CI—confidence interval • ACOG—American College of Obstetricians and Gynecologists

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Accepted Mar 3, 2008.

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