Antecedents of epilepsy and seizures among children born at extremely low gestational age

Abstract

Objective: To identify specific risk factors for epilepsy for individuals born extremely preterm. Study Design: In a prospective cohort study, at 10 year follow-up, children were classified as having epilepsy or seizures not associated with epilepsy. We evaluated for association of perinatal factors using time-oriented, multinomial logistic regression models. Results: Of 888 children included in study, 66 had epilepsy and 39 had seizures not associated with epilepsy. Epilepsy was associated with an indicator of low socioeconomic status, maternal gestational fever, early physiologic instability, postnatal exposure to hydrocortisone, cerebral white matter disease and severe bronchopulmonary dysplasia. Seizure without epilepsy was associated with indicators of placental infection and inflammation, and hypoxemia during the first 24 postnatal hours. Conclusion: In children born extremely preterm, epilepsy and seizures not associated with epilepsy have different risk profiles. Though both profiles included indicators of infection and

Prenatal tobacco smoke exposure and neurological impairment at 10 years of age among children born extremely preterm: a prospective cohort

“…Our results contrast with prior cohort studies that have focused on the association between prenatal tobacco exposure and febrile seizures, not epilepsy 6 . Only a small proportion of children who develop epilepsy had febrile seizures during infancy 43–46 .…”

“…Our results contrast with prior cohort studies that have focused on the association between prenatal tobacco exposure and febrile seizures, not epilepsy. 6 Only a small proportion of children who develop epilepsy had febrile seizures during infancy. [43][44][45][46] With that caveat about the relevance of the association between febrile seizures and later epilepsy, whether the risk of febrile seizures is increased among the offspring of women who smoked remains controversial.…”

“…4 Prenatal tobacco exposure is likely the largest modifiable risk factor for preterm birth and low infant birthweight. 5 Compared with infants born at term, those born extremely preterm <28 weeks of gestation are at more than twice the risk of neurological impairment, including epilepsy, 6 autism spectrum disorder 7 and cognitive impairment, 8 regardless of prenatal tobacco smoke exposure. Beyond this, exposure to prenatal tobacco smoke is associated with delays in fine and gross motor function and impaired cognitive abilities, regardless of gestational age at birth.…”

A Novel Parent Questionnaire for the Detection of Seizures in Children of Spanish-Speaking Families

“…The English version of this survey has been used for research and to screen high-risk populations in clinical settings. 11,23,24 With such a high negative predictive value of 97.2% in the Spanish version, this tool could be used by physicians or other trained medical staff to screen, by phone or in person, patients with a seizurelike event needing additional care or testing. If a patient screens negative on the survey, it is unlikely that he or she has seizures.…”

Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm

“…In the ELGAN cohort, factors indicative of socioeconomic disadvantage are associated with short and long health outcomes. 28,[154][155][156][157][158][159][160][161][162][163][164] Indicators of mother's low SES that are associated with an increased risk of executive dysfunctions include young age at the time of the delivery, not married, low level of educational achievement, eligibility for government-provided medical-care insurance, and smoking cigarettes during pregnancy. 165 Low education status at time of birth is also associated with substantial neurodevelopmental impairment with scores ≥2 standard deviations below normative expectation.…”