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Seizures in infancy in the offspring of women with epilepsy
Frank J E Vajda1,2, Terence J O'Brien1,2, Janet E Graham1
1Department of Medicine and Neurosciences, Royal Melbourne Hospital and University of Melbourne, Parkville, Vic., Australia.
Insights
Infants born to mothers with epilepsy have a 2.40% incidence of seizures in their first year of life. Maternal epilepsy type and seizure control during pregnancy are key factors influencing infant seizure risk.
Area of Science:
- Neurology
- Pediatrics
- Obstetrics
Background:
- Epilepsy affects numerous pregnancies globally.
- Understanding risks for offspring is crucial for prenatal counseling.
- Limited data exists on seizure incidence in infants of epileptic mothers.
Purpose of the Study:
- To determine the incidence of seizures in infants during their first year of life.
- To identify factors associated with increased seizure risk in these infants.
Main Methods:
- Analysis of data from the Australian Register of Antiepileptic Drugs in Pregnancy.
- Longitudinal follow-up of infants for one year post-birth.
Main Results:
- Overall seizure incidence was 2.40% in infants of mothers with epilepsy.
- Febrile seizures occurred in 0.92% of infants, higher than the general population.
- Infants of mothers with generalized epilepsy and those with uncontrolled seizures during pregnancy had higher risks.
- Fetal malformations were also associated with increased seizure likelihood.
Conclusions:
- Findings provide valuable information for counseling mothers with epilepsy.
- Achieving maternal seizure control throughout pregnancy is recommended.
- Monitoring infants for seizures, especially those with risk factors, is important.
Objectives:
To assess (a) the incidence of seizures in the first year of life in infants born to mothers with epilepsy and (b) factors that might contribute to the seizure incidence.
Materials & Methods:
Analysis of data collected in the Australian Register of Antiepileptic Drugs in Pregnancy during and at the end of the year after pregnancy.
Results:
By the end of a year following pregnancy, seizures had occurred in the progeny of 47 pregnancies (2.40%), including febrile seizures in 18 (0.92%), the latter rate being higher than the 0.40% and 0.59% rates for the same situation in the general population reported in the recent literature. Seizures in infancy were more likely in the offspring of mothers with generalized as compared with focal epilepsies (3.65% vs 1.56%; RR = 2.332; P < .05) and within the generalized epilepsy mothers in those who were not seizure free during pregnancy (4.83% vs 2.89%). Seizures were also more likely in infants with foetal malformations, especially ones not discovered until after the first post-natal month.
Conclusions:
These findings may help in advising mothers with epilepsy regarding the chance of their offspring experiencing seizures in the first year of life; they also suggest the desirability of achieving maternal seizure control throughout pregnancy.
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