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ARTICLES:
Yuelian Sun, Mogens Vestergaard, Jakob Christensen, André J. Nahmias, and Jørn Olsen
Prenatal Exposure to Maternal Infections and Epilepsy in Childhood: A Population-Based Cohort Study
Pediatrics 2008; 121: e1100-e1107 [Abstract] [Full text] [PDF]
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[Read P3R] Risk factors for epilepsy in childhood: Maternal symptoms and infections
Ahmet Sert   (2 June 2008)

Risk factors for epilepsy in childhood: Maternal symptoms and infections 2 June 2008
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Ahmet Sert,
M.D.
Konya Training and Research Hospital, Department of Pediatrics

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Re: Risk factors for epilepsy in childhood: Maternal symptoms and infections

ahmetsert2{at}hotmail.com Ahmet Sert

I read with interest the original article entitled ‘’Prenatal exposure to maternal infections and epilepsy in childhood: a population- based cohort study’’ in the Pediatrics 2008; 121(5):e1100-7. Sun Y et al. undertook a population-based cohort study analysis of 90 619 singletons who were born between September 1997 and June 2003 in the Danish National Birth Cohort and followed them up to December 2005. They described that 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 (1). However, causes of the patients’ coughs were not presented. Cough is a reflex action of the respiratory tract that is used to clear the upper airways. Chronic cough lasting for more than 8 weeks is common in the community. The causes include cigarette smoking, exposure to cigarette smoke, and exposure to environmental pollution, especially particulates. Diseases causing chronic cough include asthma, eosinophilic bronchitis, gastro-oesophageal reflux disease, postnasal drip syndrome or rhinosinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis, and bronchiectasis (2). So, I believe that all the coughs could not be related to infectious causes and that therefore it can not be generalized about the maternal infections due to coughs. On the other hand, all the diarrheas could not be related to infectious causes. However, a number of disorders may cause this condition, including a malabsorption syndrome and various enteropathies. Information on other infections in their study may have been based on symptoms or clinical examinations. Sun Y et al. indicates an association between some types of maternal infection and the risk for epilepsy in childhood. However, Ehrenstein et al. concluded that 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 (3). On the other hand, Cansu et al. showed an increased risk for epilepsy with a history of atypical febrile seizure (21.97-fold), severe and moderate head injury (27.76- and 7.09-fold respectively), CNS infection (4.76-fold), history of epilepsy in first-, secondary third-degree relatives (6.42-, 3.09- and 2.66-fold, respectively), presence of maternal hypertension (4.31-fold), an apgar score ≤6 at any time (7.78-fold) and neonatal jaundice (3.12-fold). Abnormal neurological signs increased the epilepsy risk 5.92 times (4). I think that it should be researched further risk factors in children with epilepsy by means of laboratory investigations during pregnancy and postnatal period.

References 1. Sun Y, Vestergaard M, Christensen J, Nahmias AJ, Olsen J. Prenatal exposure to maternal infections and epilepsy in childhood: a population- based cohort study. Pediatrics. 2008;121(5):e1100-7. 2. Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet. 2008;371(9621):1364-74. 3.Ehrenstein V, Pedersen L, Holsteen V, Larsen H, Rothman KJ, Sørensen HT. Postterm delivery and risk for epilepsy in childhood. Pediatrics. 2007;119(3):e554-61. 4. Cansu A, Serdaroğlu A, Yüksel D, Doğan V, Ozkan S, Hirfanoğlu T, Senbil N, Gücüyener K, Soysal S, Camurdan A, Gürer YK. Prevalence of some risk factors in children with epilepsy compared to their controls. Seizure. 2007;16(4):338-44.

Conflict of Interest:

None declared