Rachana Singh1, Laurie M Douglass2, T Michael O'Shea3, Carl E Stafstrom4, Elizabeth N Allred5,6, Stephen Engelke7, Bhavesh Shah8, Alan Leviton5,6, Timothy C Hereen2, Karl C K Kuban2. 1. Baystate Children's Hospital, Springfield, MA, USA. Rachana.singhmd@baystatehealth.org. 2. Department of Pediatrics, Division of Pediatric Neurology, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA. 3. University of North Carolina, Chapel Hill, NC, USA. 4. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, MA, USA. 6. Department of Neurology, Harvard Medical School, Boston, MA, USA. 7. Department of Pediatrics, East Carolina University Brody School of Medicine, Greenville, NC, USA. 8. Baystate Children's Hospital, Springfield, MA, USA.
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.
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.
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