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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 the 888 children included in the 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. CONCLUSIONS:In children born extremely preterm, epilepsy and seizures not associated with epilepsy have different risk profiles. Though both profiles included indicators of infection and inflammation, the profile of risk factors for epilepsy included multiple indicators of endogenous vulnerability.

SUBMITTER: Singh R

PROVIDER: S-EPMC7216413 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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

Singh Rachana R Douglass Laurie M LM O'Shea T Michael TM Stafstrom Carl E CE Allred Elizabeth N EN Engelke Stephen S Shah Bhavesh B Leviton Alan A Hereen Timothy C TC Kuban Karl C K KCK

Journal of perinatology : official journal of the California Perinatal Association 20190327 6

<h4>Objective</h4>To identify specific risk factors for epilepsy for individuals born extremely preterm.<h4>Study design</h4>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.<h4>Results</h4>Of the 888 children included in the study, 66 had epilepsy and 39 had seizures not associated with epilepsy. E ...[more]

PMID: 30918341

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Project description:BackgroundThe incidence of attention deficit hyperactivity disorder is higher among children born very preterm than among children who are mature at birth.MethodsWe studied 583 ten-year-old children who were born before 28 weeks of gestation whose IQ was above 84 and had a parent-completed Child Symptom Inventory-4, which allowed classification of the child as having or not having symptoms of attention deficit hyperactivity disorder. For 422 children, we also had a teacher report, and for 583 children, we also had a parent report of whether or not a physician made an attention deficit hyperactivity disorder diagnosis.ResultsThe risk profile of screening positive for attention deficit hyperactivity disorder based on a parent's report differed from the risk profile based on the teacher's report, whereas the risk profile according to a physician and according to any two observers closely resembled the parent-reported profile. Among the statistically significant risk factors were young maternal age (parent, physician, and two observers), maternal obesity (parent, physician, and two observers), maternal smoking (parent, physician, and two observers), magnesium given at delivery for seizure prophylaxis (parent and two observers), recovery of Mycoplasma sp. from the placenta (teacher and two observers), low gestational age (parent and two observers), low birth weight (teacher and physician), singleton (parent, physician, and two observers), male (parent, teacher, physician, and two observers), mechanical ventilation on postnatal day seven (physician), receipt of a sedative (parent and two observers), retinopathy of prematurity (parent), necrotizing enterocolitis (physician), antibiotic receipt (physician and two observers), and ventriculomegaly on brain scan (parent and two observers).ConclusionsThe multiplicity of risk factors identified can be subsumed as components of four broad themes: low socioeconomic state, immaturity or vulnerability, inflammation, and epigenetic phenomena.

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

Publications

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

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