Do premature and postterm birth increase the risk of epilepsy? An updated meta-analysis

Li, Wanling; Peng, Anjiao; Deng, Shuyue; Lai, Wanlin; Qiu, Xiangmiao; Zhang, Lin; Chen, Lei

doi:10.1016/j.yebeh.2019.05.016

Cited by 24 publications

(13 citation statements)

References 35 publications

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“…The results of this systematic review should be interpreted with caution, mainly due to risk of bias and heterogeneity across published studies. The most common risk of bias identified in the included studies were missing information about potential confounders and inadequate control for factors, such as preterm birth and postnatal insults, which could increase risk for neurological disorders (Cowan, 2002; Li et al, 2019). Therefore, we are unable to assess in which direction and to what extent those factors would influence the relation between a specific neurological disorder and autism.…”

Section: Discussionmentioning

confidence: 99%

Neurological disorders in autism: A systematic review and meta-analysis

Pan

Bölte

Kamal

et al. 2020

Autism

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The etiological significance of neurological disorders in autism is debated, but it is clear that they complicate support provision and clinical management, and can have negative impact on outcomes. This systematic review and meta-analysis explored the full range of co-occurring neurological disorders in autism. We estimated the odds of having neurological complications compared to the general population and other neurodevelopmental conditions, as well as the overall prevalence of different neurological disorders. Seventy-nine articles were eligible for the systematic review, including 28 case-control studies, 43 prevalence studies, and 8 cohort studies. Findings were heterogeneous across studies. Overall, autistic individuals were significantly more likely than the general population to exhibit epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headache, and congenital abnormalities of the nervous system, with prevalence estimates ranging from 1.1% (0%–3.3%; hydrocephalus) to 14.2% (11.3%–17.2%; epilepsy). Epilepsy was also more common in autism than in attention-deficit/hyperactivity disorder (odds ratio [95% confidence interval] = 4.06 [2.81–5.88]). Findings indicate that awareness of neurological disorders and neurological check-ups are indicated in autism to ensure adequate physical health care and support. Prospective studies of neurological disorders in children diagnosed with or at risk of autism might further enhance our understanding of causal pathways. Lay abstract Neurological disorders, such as epilepsy and cerebral palsy, have been reported to occur among individuals with autism beyond chance and may have an impact on daily living across the lifespan. Although there has been research investigating neurological disorders in autism, the findings are not always conclusive. Previous summaries of existing studies have not evaluated the full range of neurological disorders. This study aimed to comprehensively explore the neurological problems appearing in autism to provide updated information that is needed for better healthcare and support in this population. We looked at already published studies focusing on risk or frequency of neurological disorders in autism. Our results suggest that individuals with autism are more likely than the general population to have a range of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headache, and inborn abnormalities of the nervous system. In order to provide individualized healthcare and support of high quality to individuals diagnosed with autism, health care professionals and other support providers need to be attentive to neurological complications. To further improve our understanding about the link between autism and neurological disorders, future research should follow the neurological health of children who are diagnosed with or are at increased likelihood of autism.

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Section: Discussionmentioning

confidence: 99%

Neurological disorders in autism: A systematic review and meta-analysis

Pan

Bölte

Kamal

et al. 2020

Autism

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“…Chronic disease multimorbidity was defined as one individual having records of two or more non-communicable chronic diseases (psychiatric or somatic) during the same or subsequent secondary care episode(s). The diseases constituting multimorbidity were selected based on evidence on commonly occurring diseases among preterm and term born adolescents and young adults [21,24,25,[36][37][38][39][40][41][42][43][44]. Multimorbidity was identified using data on both in-patient and out-patient hospital care (referred to in the Nordic context as specialised healthcare), based on diagnostic codes listed in S1…”

Section: Chronic Disease Multimorbiditymentioning

confidence: 99%

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

et al. 2021

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Background People who were born prematurely have high risks of many individual diseases and conditions in the early part of the life course. However, our knowledge of the burden of multiple diseases (multimorbidity) among prematurely born individuals is limited. We aimed to investigate the risk and patterns of chronic disease multimorbidity in adolescence and early adulthood among individuals born across the spectrum of gestational ages, comparing preterm and full-term born individuals. Methods and findings We used individual-level data from linked nationwide registers to examine the associations of gestational age at birth with specialised healthcare records of ≥2 chronic diseases (multimorbidity) in adolescence (age 10–17 years) and early adulthood (age 18–30 years). Our study population comprised 951,116 individuals (50.2% females) born alive in Finland between 1st January 1987 and 31st December 2006, inclusive. All individuals were followed from age 10 years to the onset of multimorbidity, emigration, death, or 31 December 2016 (up to age 30 years). We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for multimorbidity using flexible parametric survival models. During 6,417,903 person-years at risk (median follow-up: 7.9 years), 11,919 individuals (1.3%) had multimorbidity in adolescence (18.6 per 10,000 person-years). During 3,967,419 person-years at risk (median follow-up: 6.2 years), 15,664 individuals (1.7%) had multimorbidity in early adulthood (39.5 per 10,000 person-years). Adjusted HRs for adolescent multimorbidity, comparing preterm to full-term born individuals, were 1.29 (95% CI: 1.22 to 1.36) and 1.26 (95% CI: 1.18 to 1.35) in females and males, respectively. The associations of preterm birth with early adult multimorbidity were less marked, with the adjusted HRs indicating 1.18-fold risk in females (95% CI: 1.12 to 1.24) and 1.10-fold risk in males (95% CI: 1.04 to 1.17). We observed a consistent dose-response relationship between earlier gestational age at birth and increasing risks of both multimorbidity outcomes. Compared to full-term born males, those born at 37–38 weeks (early term) had a 1.06-fold risk of multimorbidity in adolescence (95% CI: 0.98 to 1.14) and this risk increased in a graded manner up to 6.85-fold (95% CI: 5.39 to 8.71) in those born at 23–27 weeks (extremely premature), independently of covariates. Among females, the same risks ranged from 1.16-fold (95% CI: 1.09 to 1.23) among those born at 37–38 weeks to 5.65-fold (95% CI: 4.45 to 7.18) among those born at 23–27 weeks. The corresponding risks of early adult multimorbidity were similar in direction but less marked in magnitude, with little difference in risks between males and females born at 36–37 weeks but up to 3-fold risks observed among those born at 23–27 weeks. Conclusions Our findings indicate that an earlier gestational age at birth is associated with increased risks of chronic disease multimorbidity in the early part of the life course. There are currently no clinical guidelines for follow-up of prematurely born individuals beyond childhood, but these observations suggest that information on gestational age would be a useful characteristic to include in a medical history when assessing the risk of multiple chronic diseases in adolescent and young adult patients.

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“…Neonatal morbidity was 34%, 24%, and 17% at 34, 35, and 36 weeks of gestation, respectively, compared to 39 weeks of gestation [ 13 ]. Premature birth is associated with increased mortality among infants [ 12 , 15 , 16 , 17 ], throughout adulthood [ 16 , 18 ], and offspring morbidity across the lifespan [ 12 , 19 ], including psychiatric disorders [ 20 ] and social difficulties [ 21 , 22 ], with the risk of epilepsy during childhood increasing in premature newborns [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Is preterm birth associated with intimate partner violence and maternal malnutrition during pregnancy in Ethiopia? A systematic review and meta analysis

Getaneh

Memiah

Akalu

et al. 2021

Heliyon

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Background: Despite remarkable progress in the reduction of under-five mortality, preterm birth associated mortality and morbidity remains a major public health problem in Sub-saharan Africa. In Ethiopia, study findings on the association of preterm birth with intimate partner violence and maternal malnutrition have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled effect of intimate partner violence and maternal malnutrition on preterm birth. Methods: International databases including PubMed, Web of Science, SCOPUS, CINAHL, PsycINFO, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies and/or predictors were included. I 2 statistics and Egger's test were used to assess the heterogeneity and publication biases of the studies. A random-effects model was computed to estimate the prevalence and its determinants of preterm birth. Results: The random effects meta-analysis showed that a pooled national prevalence of preterm birth was 13% (95% CI: 10.0%, 16.0%). The highest prevalence of preterm birth was 25% (95% CI: 21.0%, 30.0%) in Harar, and the lowest prevalence was 8% in Southern Nations Nationalities People of Representatives. The meta-analysis suggested a decrease in preterm birth of up to 61% among women receiving antenatal care [POR ¼ 0.39 (95% CI: 0.21, 0.72)]. Women who experienced intimate partner violence [POR ¼ 2.52 (95% CI: 1.68, 3.78)], malnutrition during pregnancy [POR ¼ 2.00 (95% CI: 1.16, 3.46)], and previous preterm birth [POR ¼ 3.73 (95% CI: 2.37, 5.88)] had significantly higher odds of preterm birth. Conclusion: One in every eight live births in Ethiopia were preterm. Women who experienced intimate partner violence, malnutrition, and had previous preterm exposure were significantly associated with preterm birth. Thus, improving antenatal care visits and screening women who experience previous preterm birth are key interventions. The Federal Ministry of Health could be instrumental in preventing intimate partner violence and improving the nutritional status of pregnant women through proper and widespread implementation of programs to reduce preterm birth.

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Do premature and postterm birth increase the risk of epilepsy? An updated meta-analysis

Cited by 24 publications

References 35 publications

Neurological disorders in autism: A systematic review and meta-analysis

Neurological disorders in autism: A systematic review and meta-analysis

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

Is preterm birth associated with intimate partner violence and maternal malnutrition during pregnancy in Ethiopia? A systematic review and meta analysis

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