Gestational age is a term that refers to how far along a pregnancy is. Infants born earlier than a gestational age of 37 weeks are considered preterm (or premature). Premature birth has been scientifically shown to increase a person’s risk of epilepsy. Research shows that the risk of developing epileptic seizures during your childhood or adulthood decreases as your gestational age increases.
If an infant is born preterm or prematurely, it doesn’t necessarily mean they will go on to have epilepsy. And if an infant does have epilepsy, their epileptic seizures may not begin right away, either. Seizures may be diagnosed later during childhood.
Understanding how a premature birth may affect your child is critical for catching their epilepsy early and getting them the health care they need. Here’s what’s known about the risk of epilepsy with premature birth, what to watch for, and what your management options are.
Research has examined epilepsy diagnoses made in childhood and adulthood after a premature birth.
One large study conducted in Sweden examined more than 630,000 adults between the ages of 25 and 37 years. This analysis discovered that people who were born at a very premature gestational age (between 23 and 31 weeks) were 5 times more likely to be hospitalized later in their lives due to epilepsy compared to those who were born full-term (between 37 and 42 weeks).
Adults who were born in the middle — between 32 and 36 weeks — were also more likely to have epilepsy-induced hospitalizations compared to people born full-term. This risk was slightly lower than the risk of people with very premature births. Looking at medication rather than hospitalizations, people born preterm were also more likely to be prescribed antiepileptic drugs (AEDs) compared to people born full-term.
Other research supports the idea that premature birth is associated with epilepsy, and extends the findings from adults to children. One 2017 study conducted in Finland, which included over 1 million infants, found that the number of children who developed epilepsy decreased as their gestational age at birth increased. Importantly, preterm birth predicted an increased risk of epilepsy during a person’s childhood. In a different, four-year-long study of nearly 200 children in Connecticut, the average age at which the children got an epilepsy diagnosis was 3.7 years old.
Another Swedish study, this one from a lightly populated area in the north of that country, showed that preterm birth is associated with epilepsy diagnosis before 15 years of age.
Findings from a large meta-analysis (a statistical analysis of many independent studies) further support these findings. Researchers found that preterm birth was strongly associated with a higher risk of epilepsy throughout childhood that persisted into adulthood.
Why does this connection between premature birth and epilepsy exist? Some researchers believe that the underlying reason may involve brain injury related to oxygen deprivation before birth. This oxygen deprivation could be due to the same pregnancy complications that may have led to a preterm birth. The association may also exist due to impaired brain development that resulted from the preterm birth itself.
If your child may be at risk of epilepsy because of a preterm birth, it’s important to know the signs. Epilepsy in a child can look very similar to epilepsy in an adult. Several common signs of seizures and epilepsy include:
Read more about the types of epilepsy and their symptoms.
An electroencephalogram (EEG) should be used by a specialist (such as a neurologist) to diagnose epilepsy or another seizure disorder. A pediatric specialist may also be necessary.
The goal of epilepsy treatment in children is to reduce seizures as much as possible. There are several ways that seizures can be managed. Medication is one option. There are also non-drug treatments such as a ketogenic diet and vagus nerve stimulation. Surgery may also be an option in some special cases.
Read more about treating epilepsy.
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Are you or a loved one living with epilepsy? Were you or they born prematurely? Share your experience in the comments below or start a conversation by posting on MyEpilepsyTeam.