Childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from Norway, Australia and Canada. Issue 2 (29th June 2021)

• Record Type: Journal Article
• Authors: Oakley, Laura L; Regan, Annette K; Fell, Deshayne B; Spruin, Sarah; Bakken, Inger Johanne; Kwong, Jeffrey C; Pereira, Gavin; Nassar, Natasha; Aaberg, Kari M; Wilcox, Allen J; Håberg, Siri E
• Is Part Of: Archives of disease in childhood. Volume 107:Issue 2(2022)
• Page Start: 153
• Page End: 159
• Publication Date: 2021-06-29
• Subjects: epidemiology -- neurology; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2021-322210
• Languages: English
• ISSNs: 0003-9888

Abstract

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. Abstract : This registry based study demonstrates a link between seizures in childhood and prenatal exposure to maternal influenza. This relationship was strong for febrile seizures, but not statistically significant for children with epilepsy.