Objective To investigate the prevalence of seizures/febrile seizures in children up to 3 years of age and examine the effects of gestational age at birth on the risk for febrile seizures.
Design Retrospective longitudinal population-based cohort study.
Setting Kobe City public health center
, Kobe, Japan, from 2010 to 2018.
Participants Children who underwent a medical check-up at 3 years of age.
Methods Information regarding seizures was collected from the parents of 96 014 children. We identified the occurrence of seizure/febrile seizure in 74 017 children, whose gestational ages at birth were noted. We conducted a multivariate analysis with the parameter, gestational age at birth, to analyse the risk of seizure. We also stratified the samples by sex and birth weight (<2500 g or not) and compared the prevalence of seizure between those with the term and late preterm births.
Results The prevalence of seizure was 12.1% (11.8%–12.3%), 13.2% (12.2%–14.4%), 14.6% (12.4%–17.7%) and 15.7% (10.5%–22.8%) in children born at 37–41, 34–36, 28–33 and 22–27 gestational weeks, respectively. The prevalence of febrile seizures was 9.0% (8.8%–9.2%), 10.5% (9.5%–11.5%), 11.8% (9.7%–14.5%) and 11.2% (6.9%–17.7%) in children born at 37–41, 34–36, 28–33 and 22–27 gestational weeks, respectively. Male was an independent risk factor for seizures (OR: 1.15, 95% CI 1.09 to 1.20; absolute risk increase 0.014, 95% CI 0.010 to 0.019) and febrile seizures (OR: 1.21, 95% CI 1.15 to 1.28; absolute risk increase 0.016, 95% CI 0.012 to 0.020), respectively. Late preterm birth was not associated with an increased risk of seizure/febrile seizure.
Conclusions Although very preterm birth may increase the risk of seizure/febrile seizure, the risk associated with late preterm birth is considerably small and less than that associated with male.
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Contributors MN designed the project, participated in the data analysis and first drafted the manuscript. HM and HN designed and supervised the project and critically reviewed and revised the manuscript for important intellectual content. HY and HT supported in the data analysis and revised the manuscript for important intellectual content. YI participated in the interpretation of results and revised the manuscript for important intellectual content. KT participated in the data cleaning, supported in the data analysis and revised the manuscript for important intellectual content. NN supported in the analysis and interpretation and revised the manuscript for important intellectual content. KN participated in the data analysis and interpretation of results, and revised the manuscript for important intellectual content. KI contributed to data analysis and interpretation, critical revision of the article and final approval of the version to be published. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding This work was partly supported by Grants-in-Aid for Young Scientists of the Japan Society for the Promotion of Science KAKENHI (grant number: 18K15711) and the Kobe Public Health Research for Mothers and Children.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Approval was obtained from the review board of the Public Health Center of the city of Kobe (on 18 June 2018).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available. Data are not publicly available. However, data may be obtained from the appropriate section in Kobe City on reasonable request.
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