Preterm birth and risk of epilepsy in Swedish adults
Abstract
Objective:
To determine whether preterm birth is associated with epilepsy in a national cohort of adults aged 25–37 years.
Methods:
We conducted a national cohort study of 630,090 infants born in Sweden from 1973 through 1979, including 27,953 born preterm (<37 weeks), followed from 2005 to 2009 for 1) hospitalization for epilepsy and 2) outpatient and inpatient prescription of antiepileptic drugs. Epilepsy diagnoses and medication data were obtained from all hospitals and pharmacies throughout Sweden.
Results:
We found a strong association between preterm birth and epilepsy that increased by earlier gestational age. After adjusting for fetal growth and potential confounders, odds ratios for hospitalization for epilepsy were 4.98 (95%confidence interval [CI] 2.87–8.62) for those born at 23–31 weeks, 1.98 (95% CI 1.26–3.13) for those born at 32–34 weeks, and 1.76 (95% CI 1.30–2.38) for those born at 35–36 weeks, relative to those born full-term (37–42 weeks). A similar but slightly weaker trend was observed for the association between preterm birth and antiepileptic drug prescription. These associations persisted after excluding individuals with cerebral palsy, inflammatory diseases of the CNS, cerebrovascular disease, and brain tumors.
Conclusions:
These findings suggest that preterm birth, including late preterm birth, is strongly associated with epilepsy in Swedish adults aged 25–37 years. This association was independent of fetal growth and was not mediated by cerebral palsy or other comorbidities.
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Copyright © 2011 by AAN Enterprises, Inc.
Publication History
Received: March 10, 2011
Accepted: June 14, 2011
Published online: October 3, 2011
Published in print: October 4, 2011
Disclosure
Dr. Crump and Dr. K. Sundquist report no disclosures. Dr. Winkleby serves on scientific advisory boards for the NIH CTSA, University of California, San Diego, and the Robert Wood Johnson Latino Network, University of California, Los Angeles; serves as a consultant for Health Point Institute, Mountain View, CA; and receives research support from the NIH (NHLBI, NICHD, NIDA), the Howard Hughes Medical Institute and Health Trust. Dr. J. Sundquist reports no disclosures.
Authors
Author Contributions
C.C. conceived the study, analyzed and interpreted the data, and drafted the article. M.W., K.S., and J.S. made substantial contributions to the study design and data interpretation and critically revised the manuscript for important intellectual content. All authors approved the final version.
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