Okabe Hisao, Hashimoto Koichi, Yamada Mika, Ono Takashi, Yaginuma Kazufumi, Kume Yohei, Chishiki Mina, Sato Akiko, Ogata Yuka, Imaizumi Karin, Murata Tsuyoshi, Kyozuka Hyo, Nagasaka Yuichi, Yasumura Seiji, Nishigori Hidekazu, Fujimori Keiya, Hosoya Mitsuaki, Go Hayato
Fukushima Regional Center for the Japan Environment and Children's Study, Fukushima, Japan.
Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan.
PLoS One. 2025 Mar 28;20(3):e0321061. doi: 10.1371/journal.pone.0321061. eCollection 2025.
Recently, episodes of exanthema subitum (ES) have been occurring later than expected in Japanese patients, though the effects of this delayed timing remain unclear. Therefore, this study examined the association between ES timing and febrile seizure (FS) in Japanese children. Information on the diagnoses of ES and FS was obtained from the Japan Environment and Children's Study, a nationwide prospective birth cohort study including 97,410 mothers and their children. Two groups were created: early ES (first ES episode between birth and 11 months of age) and late ES (first ES episode between 12 and 23 months of age) groups. Multivariate logistic regression analyses were performed to compare the cumulative incidence rate of FS between the groups. Moreover, because a single episode of fever implies that the ES and FS occurred simultaneously, we examined the association between the ES timing and the simultaneous co-occurrence of FS with ES in a limited cohort with one fever episode until the age of 24 months. In total, 27,238 full-term children were included, with 12,565 (46.1%) in the early ES group and 14,673 (53.9%) in the late ES group. Late ES was estimated to increase the cumulative incidence risk of FS until the age of 24 months (adjusted odds ratio 1.46; 95% confidence interval [1.32-1.61]) and 48 months (1.26 [1.15-1.37]). The limited cohort included 1,022 children, and late ES was estimated to increase the risk of FS with ES (4.39 [1.48-13.02]). Late ES is estimated to increase the risk of FS. Further basic research and cohort studies, including virological examinations, are required to elucidate the pathogenesis of ES with FS.
最近，日本患者幼儿急疹（ES）的发病时间比预期晚，不过这种延迟的影响尚不清楚。因此，本研究调查了日本儿童ES发病时间与热性惊厥（FS）之间的关联。ES和FS的诊断信息来自日本环境与儿童研究，这是一项全国性的前瞻性出生队列研究，纳入了97410名母亲及其子女。研究分为两组：早期ES组（出生至11个月大时首次出现ES发作）和晚期ES组（12至23个月大时首次出现ES发作）。进行多因素logistic回归分析以比较两组间FS的累积发病率。此外，由于单次发热意味着ES和FS同时发生，我们在一个24个月龄前仅有一次发热发作的有限队列中，研究了ES发病时间与FS和ES同时发生之间的关联。总共纳入了27238名足月儿童，其中早期ES组有12565名（46.1%），晚期ES组有14673名（53.9%）。据估计，晚期ES会增加24个月龄前FS的累积发病风险（调整优势比1.46；95%置信区间[1.32 - 1.61]）以及48个月龄时的发病风险（1.26 [1.15 - 1.37]）。有限队列包括1022名儿童，据估计晚期ES会增加FS与ES同时发生的风险（4.39 [1.48 - 13.02]）。据估计，晚期ES会增加FS的风险。需要进一步开展包括病毒学检查在内的基础研究和队列研究，以阐明ES合并FS的发病机制。
