Perinatal & Pediatric
ASSOCIATION OF MATERNAL DIABETES WITH EPILEPSY IN CHILDREN: A POPULATION-BASED BIRTH COHORT STUDY. Bénédicte Driollet* Bénédicte Driollet Emmalin Buajitti Asma Ahmed Jennifer Hutcheon Laura Rosella Seungmi Yang
Introduction. Maternal diabetes is the most common chronic disease of pregnancy and appears to be associated with neurodevelopmental disorders in the child, but the evidence is limited and quite heterogeneous, particularly concerning epilepsy. This study aims to examine the association between maternal diabetes and epilepsy in children.
Methods. We identified all in-hospital live births between 2002 and 2018 in Ontario, Canada (N= 2 105 186) and linked their health records to various administrative data, with a follow-up until March 2020. We estimated the crude and adjusted association between maternal diabetes— pre-gestational (type 1 and type 2 diabetes mellitus (T1DM and T2DM)) and gestational diabetes (GDM)—and epilepsy in children, using Cox proportional hazards models and examined the robustness of results using quantitative bias analyses.
Results. In our study population (51.3% male, mean gestational age 38.9 weeks (SD 1.8)), 160 648 (7%) children had mothers with diabetes (1.5% with PGDM and 6.1% with GDM) and 17 853 epilepsy cases were diagnosed (a median follow-up of 10.3 years). After adjusting for maternal socio-economic and clinical characteristics, children exposed to maternal diabetes had, at any time after birth, a modestly increased risk of epilepsy compared to those unexposed (aHR:1.20, 95%CI 1.13-1.27). Compared to children unexposed to maternal diabetes, the risk was higher for children exposed to T2DM (aHR:1.41, 95%CI 1.26-1.60) or exposed to T1DM (aHR:1.37, 95%CI 1.07-1.75) than those exposed to GDM (aHR:1.14, 95%CI 1.07-1.22).
Conclusion. In this population-based birth cohort study, maternal diabetes was associated with an increased risk of epilepsy in children, and this increased risk was more pronounced among mothers with pre-gestational diabetes. Monitoring and evaluation of the development of children exposed to maternal diabetes, especially pre-gestational, may be deemed necessary.