Maternal pre-eclampsia is associated with childhood epilepsy in South Carolina children insured by Medicaid

ObjectiveWe examined the association between maternal pre-eclampsia/eclampsia (PE) and childhood epilepsy.MethodsWe conducted a retrospective cohort study using linked maternal-child billing data for Medicaid births in South Carolina from 1996 through 2002, with follow-up billing data for children through December 2008. Women with PE (exposed) and children with epilepsy (outcome) were identified using ICD-9 codes. Non-singleton births, children with documented conditions known to cause abnormal brain development, and children who neither remained in Medicaid until age 6 nor were diagnosed with epilepsy were excluded.ResultsOf 95,450 mother-child pairs in the final cohort, 5460 mothers were diagnosed with PE (5.7%) and 1106 children had the outcome of epilepsy (1.2%). After controlling for potential confounders, PE was significantly associated with risk of epilepsy (OR = 1.46, 95% CI = 1.17-1.82). The increased risk of epilepsy was observed only among full-term infants, and for this subgroup, late PE (first diagnosed after 37 weeks of gestation) was significantly associated with epilepsy (OR = 1.61, 95% CI = 1.21-2.16). The association between PE and epilepsy was particularly strong for children with focal epilepsy.ConclusionPre-eclampsia is associated with childhood epilepsy. Additional research is needed to identify potential mechanisms for the association.

Research Highlights► This article demonstrates an association between pre-eclampsia and epilepsy. ► Timing of pre- eclampsia diagnosis modifies the association with epilepsy. ► Pre-eclampsia was associated only with focal and generalized nonconvulsive epilepsy.