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Mom Rheumatoid Arthritis links to epilepsy in child
Children born to mothers with rheumatoid arthritis were 26 percent more likely to develop epilepsy than children whose mothers did not have rheumatoid arthritis. Having a father with rheumatoid arthritis did not have any effect on whether the child would develop epilepsy.
For the study, researchers looked at nearly 2 million records for children born in Denmark from 1977 to 2008. The children were then followed for an average of 16 years. Of those children, 1.6 percent or 31,491 developed epilepsy. A total of 0.7 percent or 13,556 children — had mothers with rheumatoid arthritis. Mothers diagnosed with rheumatoid arthritis after their child was born were also included as they are "preclinical" to RA.
Compared to children of non-RA mothers, children of RA mothers at the time of their birth, were up to 90 percent more likely to develop epilepsy. Children whose mothers had preclinical RA were 26 percent more likely to develop epilepsy.
The results were the same after adjustments for factors such as baby's birth weight, gestational age at birth, and whether mom also had epilepsy.
Rom noted that research has shown an increased risk of epilepsy for people with autoimmune diseases such as multiple sclerosis, that directly involve the brain. However, rheumatoid arthritis does not directly affect the brain, yet has been found to increase the risk of epilepsy.
Methods: We performed a nationwide cohort study including all singletons born in Denmark from 1977 to 2008 (n = 1,917,723) through individual linkage to nationwide Danish registries. The children were followed for an average of 16 years. Main outcome measures were adjusted hazard ratios (HRs) for epilepsy with onset in early childhood (29 days–4 years), late childhood (5–15 years), adolescence/adulthood (≥15 years), and at any age until the end of follow-up (December 31, 2010).
Results: Compared to unexposed children, children exposed to maternal RA had an increased risk of early and late childhood epilepsy (adjusted HRs 1.34 [95% confidence interval (CI) 1.13–1.60] and 1.26 [95% CI 1.13–1.41]), while children exposed to maternal RA had no increased risk of epilepsy in adolescence/adulthood (HR 1.15 [95% CI 0.92–1.45]). Paternal RA was not associated with an overall risk of epilepsy in the offspring (HR 0.96 [95% CI 0.81–1.15]) or at any age. Children exposed to maternal RA in utero had a more pronounced increased risk of early childhood epilepsy than children exposed to mothers who were diagnosed with RA after childbirth (HR 1.90 [95% CI 1.26–2.86] vs HR 1.26 [95% CI 1.03–1.52], respectively [p = 0.16]).
Conclusions: Exposure to maternal RA was associated with an increased risk of childhood epilepsy, while exposure to paternal RA was not, which indicates that changes in the intrauterine environment may play a role.
Received March 13, 2016.
The study was supported by the U.S. National Institutes of Health, Danish Council for Independent Research and Augustinus Foundation.
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Elisabeth Crank is a part-time North London police officer. Her epilepsy only became apparent at 25.
After suffering a miscariage — possibly linked to her taking a low dose of carbamazepine — she decided
to not take any medication during her next pregnancy without telling anyone, not even her husband.
Image Credit: EpilepsyU.com