Reproductive risk factors for epilepsy among ten-year-old children in metropolitan Atlanta
C A Kuenneth1, C Boyle, C C Murphy
1Department of Public Health Policy and Administration, University of Michigan School of Public Health, Ann Arbor, USA.
Insights
Mothers of children with epilepsy had more adverse reproductive outcomes, including spontaneous abortions and birth defects. A history of a child with a birth defect significantly increased epilepsy risk in subsequent children.
Area of Science:
- Epidemiology
- Reproductive Health
- Pediatric Neurology
Background:
- The relationship between maternal reproductive history and childhood epilepsy risk is not well-established.
- Understanding these associations can inform preventative strategies and early identification of at-risk pregnancies.
Purpose of the Study:
- To investigate the association between specific elements of a woman's reproductive history and the risk of her child developing epilepsy.
- To identify maternal reproductive factors that may serve as predictors for childhood epilepsy.
Main Methods:
- A case-control study was conducted using a multiple-source ascertainment method to identify 10-year-old children with epilepsy and age-matched controls in metropolitan Atlanta (1985-87).
- Mothers of 107 children with epilepsy and 408 control children were interviewed regarding reproductive history.
- Analyses excluded children with known intrauterine or postnatal etiologies and adjusted for covariates like race, maternal education, income, and family history.
Main Results:
- Mothers of children with epilepsy reported significantly more previous live births and adverse reproductive outcomes compared to control mothers.
- Adverse outcomes included higher rates of spontaneous abortions, very low birthweight infants, and infants with birth defects.
- Maternal history of a child with a birth defect showed a particularly strong association with increased epilepsy risk, especially central nervous system defects (e.g., spina bifida) and Down syndrome.
Conclusions:
- Specific adverse reproductive events in a mother's history are associated with an increased risk of her child developing epilepsy.
- A prior child's birth defect, particularly CNS defects or Down syndrome, is a significant risk factor for subsequent childhood epilepsy.
- These findings highlight the importance of reproductive history in understanding epilepsy etiology and may guide future research and clinical practice.
Abstract:
The elements of a woman's reproductive history that may be associated with her risk of having a child who develops epilepsy have not been well described. To examine these possible associations, we used a multiple-source case ascertainment method to identify ten-year-old children with epilepsy who were living in the metropolitan Atlanta area in 1985-87; same-age control children were selected from public schools. To obtain reproductive history and other information, we interviewed 107 mothers of children with epilepsy and 408 mothers of control children. Twenty-nine children with a known intrauterine or postnatal aetiology were excluded from the analysis. We computed adjusted odds ratios for reproductive history characteristics, controlling for the race of the child, maternal education, census block group income, maternal pregnancy history and family history of a developmental disability. Our analyses indicated that mothers of children with epilepsy not only had more previous live births, but more previous adverse reproductive outcomes including spontaneous abortions, very low birthweight infants and infants with birth defects. The risk was especially strong for maternal history of a child with a birth defect. The specific types of birth defects reported in excess include central nervous system defects (specifically spina bifida) and Down's syndrome.
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