Wu Chun Sen, Sun Yuelian, Vestergaard Mogens, Christensen Jakob, Ness Roberta B, Haggerty Catherine L, Olsen Jørn
Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus, Denmark.
Pediatrics. 2008 Nov;122(5):1072-8. doi: 10.1542/peds.2007-3666.
Eclampsia has been found to be a strong risk factor for epilepsy in the offspring, but it is unclear whether the risk also applies to the preceding condition, preeclampsia.
We conducted a population-based cohort study of 1537860 singletons born in Denmark (1978-2004). Information on preeclampsia (mild, severe, and unspecified), eclampsia, and epilepsy was obtained from the Danish National Hospital Register. Information on gestational age, birth weight, and Apgar score was obtained from the Danish Medical Birth Registry. We used Cox proportional hazard models to estimate the incidence rate ratio of epilepsy for children who were exposed to preeclampsia or eclampsia in prenatal life.
We identified 45288 (2.9%) children who were exposed to preeclampsia (34823 to mild, 7043 to severe, and 3422 to unspecified preeclampsia) and 654 (0.04%) to eclampsia during their prenatal life. We identified 20260 people who received a diagnosis of epilepsy during up to 27 years of follow-up in the entire cohort. Prenatal exposure to preeclampsia was associated with an increased risk for epilepsy among children with a gestational age at birth of at least 37 weeks. For mild preeclampsia, the incidence rate ratios were 1.16 among children born at term and 1.68 for children born postterm; for severe preeclampsia, the incidence rate ratios were 1.41 among children born at term and 2.57 among children born postterm. No associations between preeclampsia and epilepsy were found among children who were born preterm. Eclampsia was associated with epilepsy with an incidence rate ratio of 1.29 for children born at term and 5.03 for children born postterm.
Prenatal exposure to both preeclampsia and eclampsia was associated with an increased risk of epilepsy in children born after 37 weeks of gestation.
子痫已被发现是后代患癫痫的一个重要危险因素，但尚不清楚这种风险是否也适用于子痫前期这一前驱病症。
我们对丹麦1978年至2004年出生的1537860名单胎婴儿进行了一项基于人群的队列研究。子痫前期（轻度、重度和未明确分类）、子痫和癫痫的信息来自丹麦国家医院登记册。孕周、出生体重和阿氏评分的信息来自丹麦医疗出生登记册。我们使用Cox比例风险模型来估计产前暴露于子痫前期或子痫的儿童患癫痫的发病率比。
我们确定了45288名（2.9%）在产前暴露于子痫前期的儿童（34823名暴露于轻度子痫前期，7043名暴露于重度子痫前期，3422名暴露于未明确分类的子痫前期）以及654名（0.04%）在产前暴露于子痫的儿童。在整个队列长达27年的随访期间，我们确定了20260名被诊断为癫痫的人。产前暴露于子痫前期与出生孕周至少为37周的儿童患癫痫的风险增加有关。对于轻度子痫前期，足月儿的发病率比为1.16，过期产儿的发病率比为1.68；对于重度子痫前期，足月儿的发病率比为1.41，过期产儿的发病率比为2.57。在早产儿中未发现子痫前期与癫痫之间存在关联。子痫与癫痫有关，足月儿的发病率比为1.29，过期产儿的发病率比为5.03。
产前暴露于子痫前期和子痫均与妊娠37周后出生的儿童患癫痫的风险增加有关。
