Mikko Hirvonen1, Riitta Ojala2, Päivi Korhonen2, Paula Haataja2, Kai Eriksson3, Mika Gissler4, Tiina Luukkaala5, Outi Tammela2. 1. Department of Pediatrics, Central Finland Central Hospital, Central Finland Health Care District, Keskussairaalantie 19, FI-40620 Jyväskylä, Finland; Tampere Center for Child Health Research, University of Tampere, Kalevantie 4, FI-33014 Tampere, Finland. Electronic address: mikko.hirvonen@ksshp.fi. 2. Tampere Center for Child Health Research, University of Tampere, Kalevantie 4, FI-33014 Tampere, Finland; Department of Pediatrics, Tampere University Hospital, PO Box 2000, FI-33521 Tampere, Finland. 3. Tampere Center for Child Health Research, University of Tampere, Kalevantie 4, FI-33014 Tampere, Finland; Department of Pediatric Neurology, Tampere University Hospital, PO Box 2000, FI-33521 Tampere, Finland. 4. National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, 171 77 Stockholm, Sweden. 5. Research and Innovation Center, Tampere University Hospital, PO Box 2000, FI-33521 Tampere, Finland; Health Sciences, Faculty of Social Sciences, University of Tampere, Kalevantie 4, FI-33014 Tampere, Finland.
Abstract
OBJECTIVES: The aim was to compare the incidence of epilepsy between very preterm (VP) (<32+0 weeks), moderately preterm (MP) (32+0-33+6 weeks), late preterm (LP) (34+0-36+6 weeks) and term infants (≥37 weeks) and to establish and compare risk factors of epilepsy in these groups. METHODS: The national register study included all live born infants in Finland in 1991-2008. Excluding infants with missing gestational age, a total of 1,033,349 infants were included in the analysis and they were analyzed in four subgroups (VP, MP, LP and term) and three time periods (1991-1995, 1996-2001 and 2002-2008). RESULTS: 5611 (0.54%) children with epilepsy were diagnosed. The incidence of epilepsy was 2.53% in the VP, 1.08% in the MP, 0.75% in the LP and 0.51% in the term group. Intracranial hemorrhage (OR 3.48; 95% CI 2.47-4.89) and convulsions in the neonatal period (OR 13.4; 95% CI 10.2-17.6) were associated with an increased risk of epilepsy. Compared to the term group, preterm birth (VP OR 4.59; 95% CI 3.79-5.57, MP 1.97; 1.48-2.63, LP 1.44; 1.25-1.68) was associated with an increased risk of epilepsy after adjusting for maternal, pregnancy, delivery and sex variables. CONCLUSIONS: The incidence of epilepsy decreased by advancing gestational age at birth and preterm birth predicted an increased risk of epilepsy in childhood. Intracranial hemorrhage and neonatal convulsions were strongly associated with an increased risk of epilepsy.
OBJECTIVES: The aim was to compare the incidence of epilepsy between very preterm (VP) (<32+0 weeks), moderately preterm (MP) (32+0-33+6 weeks), late preterm (LP) (34+0-36+6 weeks) and term infants (≥37 weeks) and to establish and compare risk factors of epilepsy in these groups. METHODS: The national register study included all live born infants in Finland in 1991-2008. Excluding infants with missing gestational age, a total of 1,033,349 infants were included in the analysis and they were analyzed in four subgroups (VP, MP, LP and term) and three time periods (1991-1995, 1996-2001 and 2002-2008). RESULTS: 5611 (0.54%) children with epilepsy were diagnosed. The incidence of epilepsy was 2.53% in the VP, 1.08% in the MP, 0.75% in the LP and 0.51% in the term group. Intracranial hemorrhage (OR 3.48; 95% CI 2.47-4.89) and convulsions in the neonatal period (OR 13.4; 95% CI 10.2-17.6) were associated with an increased risk of epilepsy. Compared to the term group, preterm birth (VP OR 4.59; 95% CI 3.79-5.57, MP 1.97; 1.48-2.63, LP 1.44; 1.25-1.68) was associated with an increased risk of epilepsy after adjusting for maternal, pregnancy, delivery and sex variables. CONCLUSIONS: The incidence of epilepsy decreased by advancing gestational age at birth and preterm birth predicted an increased risk of epilepsy in childhood. Intracranial hemorrhage and neonatal convulsions were strongly associated with an increased risk of epilepsy.
Authors: Mads Damkjaer; Maria Loane; Stine Kjær Urhøj; Elisa Ballardini; Clara Cavero-Carbonell; Alessio Coi; Laura García-Villodre; Joanne Emma Given; Mika Gissler; Anna Heino; Susan Jordan; Amanda Neville; Anna Pierini; Joachim Tan; Ieuan Scanlon; Ester Garne; Joan K Morris Journal: BMJ Open Date: 2022-10-17 Impact factor: 3.006