Relation of pregnancy and neonatal factors to subsequent development of childhood epilepsy: a population-based cohort study.
OBJECTIVE
We examined the effect of pregnancy and neonatal factors on the subsequent development of childhood epilepsy in a population-based cohort study.


METHODS
Children born between January 1986 and December 2000 in Nova Scotia, Canada were followed up to December 2001. Data on pregnancy and neonatal events and on diagnoses of childhood epilepsy were obtained through record linkage of 2 population-based databases: the Nova Scotia Atlee Perinatal Database and the Canadian Epilepsy Database and Registry. Factors analyzed included events during the prenatal, labor and delivery, and neonatal time periods. Cox proportional hazards regression models were used to estimate relative risks and 95% confidence intervals.


RESULTS
There were 648 new cases of epilepsy diagnosed among 124,207 live births, for an overall rate of 63 per 100,000 person-years. Incidence rates were highest among children <1 year of age. In adjusted analyses, factors significantly associated with an increased risk of epilepsy included eclampsia, neonatal seizures, central nervous system (CNS) anomalies, placental abruption, major non-CNS anomalies, neonatal metabolic disorders, neonatal CNS diseases, previous low birth weight infant, infection in pregnancy, small for gestational age, unmarried, and not breastfeeding infant at the time of discharge from hospital.


CONCLUSIONS
Our study supports the concept that prenatal factors contribute to the occurrence of subsequent childhood epilepsy.
Whitehead
Elizabeth
E
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Dodds
Linda
L
Joseph
K S
KS
Gordon
Kevin E
KE
Wood
Ellen
E
Allen
Alexander C
AC
Camfield
Peter
P
Dooley
Joseph M
JM
D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000013:Congenital Abnormalities; D004827:Epilepsy / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D017533:Marital Status; D011247:Pregnancy; D011248:Pregnancy Complications; D017584:Reproductive History; D012307:Risk Factors