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. 2016 Dec 13;87(24):2510-2516.
doi: 10.1212/WNL.0000000000003424. Epub 2016 Nov 16.

Parental rheumatoid arthritis and childhood epilepsy: A nationwide cohort study

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Parental rheumatoid arthritis and childhood epilepsy: A nationwide cohort study

Ane Lilleøre Rom et al. Neurology. .

Abstract

Objective: To assess the influence of parental rheumatoid arthritis (RA) on 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.

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Figures

Figure 1
Figure 1. Identification of study population
RA = rheumatoid arthritis.
Figure 2
Figure 2. Age-specific hazard ratios (HRs) of epilepsy in offspring of parents with rheumatoid arthritis (RA)
CI = confidence interval. aNo. of children followed: 1,909,933; no. of events: any epilepsy, 31,491; early childhood, 12,838; late childhood, 12,384; adolescence/adulthood, 6,269. bAdjusted for age of the child, maternal age, maternal education, birth year, and paternal RA. cAdjusted for age of the child, maternal age, maternal education, birth year, and maternal RA. d29 days–<5 years. e5–15 years. f≥15 years. The simple adjusted estimates were similar to the presented fully adjusted estimates.

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