May 17, 2006

Babies born in poor condition at risk for epilepsy

NEW YORK (Reuters Health) - Newborns with low Apgar scores
-- indicating that they have serious physical difficulties --
are more likely to develop epilepsy during childhood and early
adulthood than those with higher scores, a Danish study shows.

Apgar scoring is a method of quickly checking newborns,
based on their heart rate, breathing, muscle tone, response to
a stimulus, and color. The maximum score is 10, and the
assessment is made at 1 minute and 5 minutes after babies are

The new findings suggest that "prenatal or perinatal
factors play a larger role in the (cause) of epilepsy than has
previously been recognized," say Dr. Yuelian Sun, from the
University of Aarhus, and associates.

The researchers identified children born between 1978 and
2002, as documented in the Danish Civil Registration System.
Apgar scores at birth were obtained from the Danish Medical
Birth Register, and information regarding epilepsy was
extracted from the National Hospital Register.

The investigators report in the research journal
Epidemiology that, among the roughly 1.5 million live-born
children, 16,455 cases of epilepsy were diagnosed by the end of
2002. This is equivalent to an average incidence rate of 91.7
cases per 100,000 persons per year of follow-up.

Epilepsy incidence increased consistently with decreasing
1- and 5-minute Apgar scores. For example, the incidence per
100,000 person-years was 628 for those with 5-minute Apgar
scores of 1 to 3, versus 86 for those with scores of 10.

The incidence of epilepsy was 8 times higher among children
with Apgar scores of 1 to 3 at both 1 and 5 minutes compared
with children with scores of 10 at both time points.

The occurrence of epilepsy associated with low Apgar score
was greatest during the first year of life, but the risk
remained elevated throughout childhood and up to 25 years of

Potential causes of epilepsy related to pregnancy and birth
"could be infections, maternal lifestyle factors, maternal
complications during pregnancy, and factors related to the
delivery process," Sun's team writes.

They believe that more research looking into the fetal and
perinatal origins of epilepsy is warranted.

SOURCE: Epidemiology, May 2006.