title: Maternal genitourinary infection appears to synergistically increase the risk of epilepsy in children of women with epilepsy.
abstract: BACKGROUND
  Evidence indicates that maternal genitourinary infection during pregnancy is associated with increased risk of epilepsy in children and that children of women with epilepsy are substantially more likely to have epilepsy themselves. Research is lacking on whether maternal genitourinary infection has a different effect on children of women with epilepsy compared to children of women without epilepsy.
  
  
  METHODS
  We conducted a retrospective cohort study using Medicaid data for 127,540 pregnancies, from 1996 to 2002, and children's data through 2008. Maternal epilepsy, genitourinary infections, and child epilepsy were identified. Epilepsy was diagnosed in 1.7% of the children in the cohort.
  
  
  RESULTS
  There was a statistically significant interaction between maternal genitourinary infection and maternal epilepsy. Maternal genitourinary infection was strongly associated with increased risk of epilepsy in children of women with epilepsy (hazard ratio = 3.74, 95% CI = 1.67-8.40). Infection was more weakly associated with increased risk of epilepsy in children of women without epilepsy (hazard ratio = 1.23, 95% CI = 1.12-1.34).
  
  
  CONCLUSIONS
  There is a significant association between genitourinary infection and childhood epilepsy, and the impact appears to be greater in children of women with epilepsy. This finding has implications for prenatal care of women with epilepsy as well as for research on antenatal risk factors for child epilepsy.
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA. suzanne.mcdermott@uscmed.sc.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: McDermott
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.forename: Junlong
authors.initials: J
authors.lastname: Wu
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004827:Epilepsy / Q000453:epidemiology*; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult