Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada

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 use...

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Main Authors: Oakley, L.L., Regan, Annette, Fell, D.B., Spruin, S., Bakken, I.J., Kwong, J.C., Pereira, Gavin, Nassar, N., Aaberg, K.M., Wilcox, A.J., Håberg, S.E.
Format: Journal Article
Language:English
Published: BMJ PUBLISHING GROUP 2022
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1099655
http://hdl.handle.net/20.500.11937/93240
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author Oakley, L.L.
Regan, Annette
Fell, D.B.
Spruin, S.
Bakken, I.J.
Kwong, J.C.
Pereira, Gavin
Nassar, N.
Aaberg, K.M.
Wilcox, A.J.
Håberg, S.E.
author_facet Oakley, L.L.
Regan, Annette
Fell, D.B.
Spruin, S.
Bakken, I.J.
Kwong, J.C.
Pereira, Gavin
Nassar, N.
Aaberg, K.M.
Wilcox, A.J.
Håberg, S.E.
author_sort Oakley, L.L.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-932402023-10-09T03:02:34Z Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada Oakley, L.L. Regan, Annette Fell, D.B. Spruin, S. Bakken, I.J. Kwong, J.C. Pereira, Gavin Nassar, N. Aaberg, K.M. Wilcox, A.J. Håberg, S.E. Science & Technology Life Sciences & Biomedicine Pediatrics epidemiology neurology EPILEPSY PREGNANCY VACCINATION PREVALENCE epidemiology neurology Adult Australia Canada Child, Preschool Female Humans Infant Infant, Newborn Influenza, Human Norway Pregnancy Pregnancy Complications, Infectious Prenatal Exposure Delayed Effects Prospective Studies Registries Seizures Young Adult Humans Pregnancy Complications, Infectious Seizures Prenatal Exposure Delayed Effects Registries Prospective Studies Pregnancy Adult Child, Preschool Infant Infant, Newborn Canada Australia Norway Female Influenza, Human Young Adult 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. 2022 Journal Article http://hdl.handle.net/20.500.11937/93240 10.1136/archdischild-2021-322210 English http://purl.org/au-research/grants/nhmrc/1099655 BMJ PUBLISHING GROUP fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Pediatrics
epidemiology
neurology
EPILEPSY
PREGNANCY
VACCINATION
PREVALENCE
epidemiology
neurology
Adult
Australia
Canada
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Influenza, Human
Norway
Pregnancy
Pregnancy Complications, Infectious
Prenatal Exposure Delayed Effects
Prospective Studies
Registries
Seizures
Young Adult
Humans
Pregnancy Complications, Infectious
Seizures
Prenatal Exposure Delayed Effects
Registries
Prospective Studies
Pregnancy
Adult
Child, Preschool
Infant
Infant, Newborn
Canada
Australia
Norway
Female
Influenza, Human
Young Adult
Oakley, L.L.
Regan, Annette
Fell, D.B.
Spruin, S.
Bakken, I.J.
Kwong, J.C.
Pereira, Gavin
Nassar, N.
Aaberg, K.M.
Wilcox, A.J.
Håberg, S.E.
Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title_full Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title_fullStr Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title_full_unstemmed Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title_short Childhood seizures after prenatal exposure to maternal influenza infection: A population-based cohort study from Norway, Australia and Canada
title_sort childhood seizures after prenatal exposure to maternal influenza infection: a population-based cohort study from norway, australia and canada
topic Science & Technology
Life Sciences & Biomedicine
Pediatrics
epidemiology
neurology
EPILEPSY
PREGNANCY
VACCINATION
PREVALENCE
epidemiology
neurology
Adult
Australia
Canada
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Influenza, Human
Norway
Pregnancy
Pregnancy Complications, Infectious
Prenatal Exposure Delayed Effects
Prospective Studies
Registries
Seizures
Young Adult
Humans
Pregnancy Complications, Infectious
Seizures
Prenatal Exposure Delayed Effects
Registries
Prospective Studies
Pregnancy
Adult
Child, Preschool
Infant
Infant, Newborn
Canada
Australia
Norway
Female
Influenza, Human
Young Adult
url http://purl.org/au-research/grants/nhmrc/1099655
http://hdl.handle.net/20.500.11937/93240