Infant Respiratory Distress Syndrome Increases Childhood Epilepsy Risk

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Infant RDS is common among preterm infants because of immature lungs and deficiency of surfactant.
Infant RDS is common among preterm infants because of immature lungs and deficiency of surfactant.

Infant respiratory distress syndrome (IRDS) in preterm infants born at 32 to 36 weeks of gestation is associated with a high risk for childhood epilepsy, according to findings from a population-based cohort study published in the European Journal of Epidemiology.

Investigators identified 6426 infants (6.8%) from a total of 95,026 infants with IRDS born at 32 to 36 weeks of gestation in the Medical Birth Registry. Children with both IRDS and epilepsy were identified through the Danish National Patient Registry.

Among patients born during the 32nd week of gestation, IRDS prevalence was 22% vs 2% in those born during gestational week 36. At follow-up, 2326 children were diagnosed with epilepsy in this cohort. Epilepsy incidence (per 100,000 person-years) was 260 (95% CI, 226-299) in those with IRDS and 156 (95% CI, 149-164) in infants who did not have IRDS.

Investigators stratified the analysis with respect to weeks of gestation and found an increased epilepsy risk in children with IRDS vs those without IRDS among all gestational periods. By age 15, the cumulative epilepsy incidence was 3.4% among children diagnosed with IRDS vs 2.1% of children without IRDS. The epilepsy adjusted hazard ratio for children with IRDS vs those without IRDS was 1.4 (95% CI, 1.2-1.6).

The investigators noted that data captured in the Danish National Patient Registry were on patients treated in hospital-based outpatient departments, resulting in the inability to apply the study's findings to nonhospitalized children with epilepsy.

The researchers also commented that an explanation for the link between IRDS and epilepsy cannot be found; however, “Hypoxia, a well-known cause of perinatal brain injury, plays a major role” in the association.

Reference

Thygesen SK, Olsen M, Pedersen L, Henderson VW, Østergaard JR, Sørensen HT. Respiratory distress syndrome in preterm infants and risk of epilepsy in a Danish cohort [published online September 8, 2017]. Eur J Epidemiol. doi:10.1007/s10654-017-0308-1

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