title: Maternal use of antibiotics, hospitalisation for infection during pregnancy, and risk of childhood epilepsy: a population-based cohort study.
abstract: BACKGROUND
  Maternal infection during pregnancy may be a risk factor for epilepsy in offspring. Use of antibiotics is a valid marker of infection.
  
  
  RESULTS
  To examine the relationship between maternal infection during pregnancy and risk of childhood epilepsy we conducted a historical cohort study of singletons born in northern Denmark from 1998 through 2008 who survived ≥29 days. We used population-based medical databases to ascertain maternal use of antibiotics or hospital contacts with infection during pregnancy, as well as first-time hospital contacts with a diagnosis of epilepsy among offspring. We compared incidence rates (IR) of epilepsy among children of mothers with and without infection during pregnancy. We examined the outcome according to trimester of exposure, type of antibiotic, and total number of prescriptions, using Poisson regression to estimate incidence rate ratios (IRRs) while adjusting for covariates. Among 191,383 children in the cohort, 948 (0.5%) were hospitalised or had an outpatient visit for epilepsy during follow-up, yielding an IR of 91 per 100 000 person-years (PY). The five-year cumulative incidence of epilepsy was 4.5 per 1000 children. Among children exposed prenatally to maternal infection, the IR was 117 per 100,000 PY, with an adjusted IRR of 1.40 (95% confidence interval (CI): 1.22-1.61), compared with unexposed children. The association was unaffected by trimester of exposure, antibiotic type, or prescription count.
  
  
  CONCLUSIONS
  Prenatal exposure to maternal infection is associated with an increased risk of epilepsy in childhood. The similarity of estimates across types of antibiotics suggests that processes common to all infections underlie this outcome, rather than specific pathogens or drugs.
authors.affiliation: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. mn@dce.au.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Nørgaard
authors.forename: Vera
authors.initials: V
authors.lastname: Ehrenstein
authors.forename: Rikke Beck
authors.initials: RB
authors.lastname: Nielsen
authors.forename: Leiv Sigmund
authors.initials: LS
authors.lastname: Bakketeig
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004827:Epilepsy / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005306:Fertilization; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology / Q000628:therapy*; D011264:Pregnancy Trimesters; D012306:Risk; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents