852: Maternal epilepsy and long- term neurological morbidity of the offspring

Abstract

Maternal epilepsy has been associated with adverse short-term perinatal outcome of the offspring. The aim of the present study was to study the possible association between maternal epilepsy and the risk for long-term neurological morbidity of the offspring. A population-based cohort study, comparing long-term neurological morbidity of offspring of mothers with and without epilepsy was conducted. All singleton deliveries between the years 1991-2014 in a tertiary medical center were included. Cases of perinatal mortality, children with congenital malformations or chromosomal abnormalities and pregnancies without prenatal care were excluded from the study. The study groups were followed until 18 years of age for neurological-related morbidity, according to a predefined set of ICD-9 codes associated with hospitalizations of the offspring. A Kaplan-Meier survival curve was used to compare cumulative incidence of long- term neurological morbidity, and a Cox proportional hazards model was constructed to control for confounders. During the study period 242,342 deliveries met the inclusion criteria, of them 0.3% (n=704) were of mothers with epilepsy. Offspring born to mothers with epilepsy had higher rates of long-term neurological morbidity (8.2% vs 3.1%, p<0.001, Table). Likewise, the cumulative incidence of long-term neurological morbidity was higher as compared with those without maternal epilepsy (Kaplan-Meier log rank test P<0.001, Figure). Using a Cox proportional hazards model, controlling for confounders such as maternal age, hypertensive disorders of pregnancy, birth-weight and diabetes mellitus, being born to a mother with epilepsy was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted HR 2.74, 95% CI 2.12-3.55; P<0.001). Being born to a mother with epilepsy is independently associated with higher risk for long-term neurological morbidity of the offspring.View Large Image Figure ViewerDownload Hi-res image Download (PPT)