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Published on: November 21, 2013
Paroxysmal disorders in infancy and their risk factors in a population-based cohort: the Generation R Study
Annemarie M Visser1, Vincent W V Jaddoe, Lidia R Arends
1The Generation R Study Group, Department of Biostatistics and Institute of Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Insights
Paroxysmal disorders are common in infants, with preterm birth and low Apgar scores being significant predictors. Maternal smoking during pregnancy also increased the risk of febrile seizures in newborns.
Area of Science:
- Pediatrics
- Neonatal Medicine
- Neurology
Background:
- Paroxysmal disorders are common in infancy, encompassing both epileptic and non-epileptic events.
- Identifying predictive factors for these disorders is crucial for early intervention and management.
Purpose of the Study:
- To determine the incidence of paroxysmal epileptic and non-epileptic disorders in the first year of life.
- To investigate prenatal and perinatal factors associated with these disorders in a population-based cohort.
Main Methods:
- Prospective, population-based cohort study (Generation R Study) from early fetal life.
- Questionnaires collected data on paroxysmal events at 2, 6, and 12 months of age.
- Prenatal and perinatal determinants were assessed through measurements and questionnaires.
Main Results:
- An incidence of 8.9% for paroxysmal disorders was observed in the first year of life.
- Preterm birth and low Apgar score at 1 minute were significantly associated with paroxysmal disorders.
- Continued maternal smoking and preterm birth were linked to an increased incidence of febrile seizures.
Conclusions:
- Paroxysmal disorders are frequent in infancy, with preterm birth and low Apgar scores as key associated factors.
- Epileptic seizures constitute a small proportion of infantile paroxysmal events.
- Maternal smoking during pregnancy is associated with a higher incidence of febrile seizures, warranting further investigation.
Aim:
To examine the incidence of paroxysmal epileptic and non-epileptic disorders and the associated prenatal and perinatal factors that might predict them in the first year of life in a population-based cohort.
Method:
This study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards. Information about the occurrence of paroxysmal events, defined as suddenly occurring episodes with an altered consciousness, altered behaviour, involuntary movements, altered muscle tone, and/or a changed breathing pattern, was collected by questionnaires at the ages of 2, 6, and 12 months. Information on possible prenatal and perinatal determinants was obtained by measurements and questionnaires during pregnancy and after birth.
Results:
Information about paroxysmal events in the first year of life was available in 2860 participants (1410 males, 1450 females). We found an incidence of paroxysmal disorders of 8.9% (n=255) in the first year of life. Of these participants, 17 were diagnosed with febrile seizures and two with epilepsy. Non-epileptic events included physiological events, apnoeic spells, loss of consciousness by causes other than epileptic seizures or apnoeic spells, parasomnias, and other events. Preterm birth (p<0.001) and low Apgar score at 1 minute (p<0.05) were significantly associated with paroxysmal disorders in the first year of life. Continued maternal smoking during pregnancy and preterm birth were significantly associated with febrile seizures in the first year of life (p<0.05).
Interpretation:
Paroxysmal disorders are frequent in infancy. They are associated with preterm birth and a low Apgar score. Epileptic seizures only form a minority of the paroxysmal events in infancy. In this study, children whose mothers continued smoking during pregnancy had a higher reported incidence of febrile seizures in the first year of life. These findings may generate various hypotheses for further investigations.
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