Epilepsy: infants born at early- and late-term pregnancies are at an increased risk

  • Odd D & al.
  • PLoS ONE
  • 1 Jan 2018

  • curated by Antara Ghosh
  • UK Clinical Digest
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Takeaway

  • Infants born at early-term pregnancy appear to have increased risk for epilepsy, childhood death and needing disability support vs those born at 39 or 40 weeks gestation.
  • Infants born at late-term pregnancy also appear to have increased risk of developing epilepsy as they grow, and higher risk of needing disability support.

Why this matters

  • Findings could guide women and care givers in making decisions regarding timing of induction of labour.
  • Enhanced surveillance to these women could help minimise potential impacts.

Study design

  • Total of 1,030,168 infants born in Sweden between 1983 and 1993 to mothers aged between 20 and 35 years at the time of delivery were evaluated.
  • Infants born at 39-40 weeks of gestation formed the reference group; infants born at 37-38 and ≥41 weeks formed early- and late/post-term groups, respectively.
  • Primary outcome: diagnosis of epilepsy before 20 years of age in infants born ≥7 days after the infants’ due date.
  • Funding: North Bristol NHS Trust Springboard Fund.

Key results

  • 25.6% infants were born at 41 weeks gestation or later, while 20.2% were born at 37/38 weeks.
  • Early-term infants had higher risk for epilepsy (aOR, 1.19; 95% CI, 1.11-1.29), child death (aOR, 1.42; 95% CI, 1.30-1.55) and disability pension (aOR, 1.20; 95% CI, 1.16-1.24) vs reference group.
  • Late-term infants had higher risk for epilepsy (aOR, 1.13; 95% CI, 1.06-1.22) and disability pension (aOR, 1.05; 95% CI, 1.01-1.08), but evidence for increased risk for child death (P=.093) was insufficient.

Limitations

  • Use of routinely collected data.
  • Presence of missing data points.

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