Pediatrics. 2007 Mar;119(3):e554-61.
Postterm delivery and risk for epilepsy in childhood.
Ehrenstein V, Pedersen L, Holsteen V, Larsen H, Rothman KJ, S?ensen HT.
Department of Epidemiology, Boston University School of Public Health,
Boston, Massachusetts, USA. verad@bu.edu
Objectives:
Postterm delivery is a risk factor for perinatal
complications, some of which increase risk for neurologic morbidity. We
aimed to examine the association between postterm delivery and risk for
epilepsy in childhood.
Methods:
We conducted a cohort study of singleton
children who were born in 3 Danish counties from 1980 to 2001. Birth
registry data were linked with hospital records to identify cases of
epilepsy in the first 12 years of life. We included children who were
born at > or = 39 gestational weeks and computed crude, age-specific,
and birth weight standardized incidence rates of epilepsy. We estimated
adjusted incidence rate ratios according to mode of delivery by Poisson
regression.
Results:
Among the 277,435 nonpreterm births, 32,557 were at
> or = 42 weeks, including 3396 at > or = 43 weeks. Nearly one fourth of
the 2805 epilepsy cases occurred in the first year of life. In that
period, birth weight standardized incidence rate ratios for epilepsy
were 1.3 for birth at 42 weeks and 2.0 for birth at > or = 43 weeks,
compared with birth at 39 to 41 weeks. Among children who were delivered
by cesarean section, incidence rate ratios adjusted for birth weight,
presentation, malformations, and county were 1.4 for birth at 42
completed weeks and 4.9 for birth at > or = 43 weeks, compared with term
vaginal births. There was a similar tendency among children who were
delivered with the assistance of instruments. We found no evidence for
the association between postterm delivery and risk for epilepsy beyond
the first year of life.
Conclusions:
Prolonged gestation is a risk
factor for early epilepsy; the added increase in risk for
instrument-assisted and cesarean deliveries could be attributable to
factors that are related to both birth complications and epilepsy.
