Prevalence and Temporal Trends of Epilepsy in Children: A Retrospective Birth Cohort Study
Bénédicte Driollet1, Emmalin Buajitti1,2,3, Asma M Ahmed4
1Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada.
Insights
Epilepsy prevalence in children slightly increased from 2002 to 2012. Disparities in childhood epilepsy rates persist based on gestational age, socioeconomic status, and maternal immigration.
Area of Science:
- Pediatric Neurology
- Epidemiology
- Public Health
Background:
- Epilepsy is a common chronic neurologic disease in children.
- Limited recent data exists on epilepsy prevalence trends and influencing factors like birth or maternal characteristics.
- Understanding these trends is crucial for public health initiatives and resource allocation.
Purpose of the Study:
- To examine the prevalence of epilepsy in children born between 2002 and 2020 in Ontario, Canada.
- To analyze temporal trends in epilepsy prevalence by year of birth.
- To investigate the influence of maternal and birth characteristics on epilepsy prevalence.
Main Methods:
- Utilized linked administrative health data for 2,343,482 in-hospital deliveries in Ontario (2002-2020).
- Estimated overall epilepsy prevalence diagnosed before age 18.
- Conducted temporal trend analyses on children born up to 2012, examining prevalence by age 8 using Poisson regression.
Main Results:
- Overall epilepsy prevalence was 8.1 per 1,000 live births.
- Higher prevalence observed in boys, preterm infants, those with congenital malformations, multiple pregnancies, and from deprived areas.
- Epilepsy prevalence diagnosed by age 8 showed a slight increase from 2002 to 2012 cohorts; disparities by gestational age and socioeconomic status remained persistent.
Conclusions:
- A slight increase in childhood epilepsy prevalence was observed between 2002 and 2012 birth cohorts in Canada.
- Persistent disparities in epilepsy prevalence exist based on gestational age, socioeconomic position, and maternal immigration status.
- Continued surveillance is recommended to monitor trends and investigate underlying causes of increasing epilepsy rates and persistent disparities.
Objective:
Epilepsy is one of the most common chronic neurologic diseases in children; however, few recent studies examine the prevalence of epilepsy and its evolution over time according to birth or maternal characteristics. The aim of the study was to examine the prevalence of epilepsy in children born between 2002 and 2020 and the temporal trends by year of birth, in Ontario, Canada, overall, and according to maternal and birth characteristics.
Methods:
We included all in-hospital deliveries between 2002 and 2020 (N = 2,343,482) in Ontario, Canada, using linked administrative health dataset. We estimated the overall prevalence of epilepsy diagnosed before the age of 18 years, by birth and maternal characteristics. For temporal trend analyses, we restricted our population to children born up to 2012 (N = 1,405,271) and examined the prevalence of epilepsy diagnosed by age 8 by their year of birth, using Poisson regression.
Results:
The overall prevalence of epilepsy in our cohort was 8.1 per 1,000 live births (95% CI: 8.0-8.2). Prevalence was higher for boys, for children born preterm, with congenital malformations, from multiple pregnancies, from mothers born in Canada, and for children living in deprived areas. Epilepsy prevalence diagnosed by age 8 increased slightly between 2002 and 2012 cohorts (6.9 [95% CI: 6.2-7.6] to 7.3 [95% CI: 6.6-8.1] per 1,000 live births, respectively). Differences by gestational age as gradient and socioeconomic characteristics were persistent and stable over time, while those by pregnancy plurality and sex decreased.
Significance:
In a large population-based birth cohort in Canada, we observed a slight increase in epilepsy prevalence over time among children born in 2002 and those born in 2012 and persistent disparities by gestational age, socioeconomic position, and maternal immigration status. This study highlights the need for continued surveillance of rates to see if this increasing trend is persistent, to understand the potential causes behind it, and to understand the persistence of these disparities.
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