Epilepsy in children exposed to family and domestic violence in the first 5 years of life.

Abstract

To investigate childhood (0-18 years) hospitalisation and emergency department (ED) contacts for epilepsy in Western Australian (WA) children exposed to family and domestic violence (FDV) pre 5 years of age compared to children with no FDV exposure. A retrospective, population-based cohort study included children born 1987-2010 who were identified as being exposed to FDV (n=7018) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n=41 996). Epilepsy contact was identified in HMDC and ED Data Collection records. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval (CI) for epilepsy contact; adjustment was made for a range of demographic characteristics known to impact health outcomes. Analyses were stratified by Aboriginal and Torres Strait Islander status to account for higher rates of FDV and epilepsy hospital admissions in Aboriginal and Torres Strait Islander children. Children exposed to FDV had a 62% (HR 1.62, 95% CI: 1.33-1.98) increased risk of epilepsy contact than non-exposed counterparts. Furthermore, the children exposed to FDV had a 50% longer average hospital stay for epilepsy than non-exposed children (4.7 days vs. 3 days, P=0.006). When stratified by Aboriginal status, we found that Aboriginal children exposed to FDV stayed (on average) 2 days longer in hospital for epilepsy than their non-exposed counterparts (5.1 days vs. 3.1 days, P=0.018). FDV exposure in early childhood is associated with increased risk of requiring secondary health care and longer hospital stays for childhood epilepsy.