Arch Dis Child . Childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada

[tetano]

Arch Dis Child


. 2021 Jun 29;archdischild-2021-322210.
doi: 10.1136/archdischild-2021-322210. Online ahead of print.
Childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada


Laura L Oakley ^{1 2} , Annette K Regan ^{3 4 5} , Deshayne B Fell ^{6 7 8} , Sarah Spruin ^{7 9} , Inger Johanne Bakken ² , Jeffrey C Kwong ^{7 10 11 12 13} , Gavin Pereira ⁴ , Natasha Nassar ¹⁴ , Kari M Aaberg ¹⁵ , Allen J Wilcox ^{2 16} , Siri E Håberg ²



Affiliations

• PMID: 34187781
• DOI: 10.1136/archdischild-2021-322210

Abstract

Objective: To assess whether clinical and/or laboratory-confirmed diagnosis of maternal influenza during pregnancy increases the risk of seizures in early childhood.
Design: Analysis of prospectively collected registry data for children born between 2009 and 2013 in three high-income countries. We used Cox regression to estimate country-level adjusted HRs (aHRs); fixed-effects meta-analyses were used to pool adjusted estimates.
Setting: Population-based.
Participants: 1 360 629 children born between 1 January 2009 and 31 December 2013 in Norway, Australia (New South Wales) and Canada (Ontario).
Exposure: Clinical and/or laboratory-confirmed diagnosis of maternal influenza infection during pregnancy.
Main outcome measures: We extracted data on recorded seizure diagnosis in secondary/specialist healthcare between birth and up to 7 years of age; additional analyses were performed for the specific seizure outcomes 'epilepsy' and 'febrile seizures'.
Results: Among 1 360 629 children in the study population, 14 280 (1.0%) were exposed to maternal influenza in utero. Exposed children were at increased risk of seizures (aHR 1.17, 95% CI 1.07 to 1.28), and also febrile seizures (aHR 1.20, 95% CI 1.07 to 1.34). There was no strong evidence of an increased risk of epilepsy (aHR 1.07, 95% CI 0.81 to 1.41). Risk estimates for seizures were higher after influenza infection during the second and third trimester than for first trimester.
Conclusions: In this large international study, prenatal exposure to influenza infection was associated with increased risk of childhood seizures.

Keywords: epidemiology; neurology.