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Mom Rheumatoid Arthritis links to epilepsy in child

A new study shows a link between mothers with rheumatoid arthritis and children with epilepsy. Rheumatoid arthritis (RA), an autoimmune disease, causes our own immune system to attack our joints. It differs from osteoarthritis, caused by wear and tear on the joints.

Children born to mothers with rheumatoid arthritis were 26 percent more likely to develop epilepsy than children whose mothers did not have rheumatoid arthritis. Having a father with rheumatoid arthritis did not have any effect on whether the child would develop epilepsy.

The study is published in the November 16, 2016, online issue of Neurology®, a medical journal of the American Academy of Neurology.

"These results suggest changes in environment for a fetus may play a role in the development of epilepsy. We don't know yet how this may work, but it could involve production of maternal antibodies that could affect the unborn child."

Ane Lilleore Rom PhD, Copenhagen University Hospital, Denmark, and study author.

For the study, researchers looked at nearly 2 million records for children born in Denmark from 1977 to 2008. The children were then followed for an average of 16 years. Of those children, 1.6 percent or 31,491 developed epilepsy. A total of 0.7 percent or 13,556 children — had mothers with rheumatoid arthritis. Mothers diagnosed with rheumatoid arthritis after their child was born were also included as they are "preclinical" to RA.

Compared to children of non-RA mothers, children of RA mothers at the time of their birth, were up to 90 percent more likely to develop epilepsy. Children whose mothers had preclinical RA were 26 percent more likely to develop epilepsy.

In absolute numbers — this translates to 2% of children whose mothers had clinical RA and 3% of children whose mothers had preclinical RA at the time of birth — later developed epilepsy.

The results were the same after adjustments for factors such as baby's birth weight, gestational age at birth, and whether mom also had epilepsy.

As children of mothers with preclinical RA also have an increased risk of epilepsy, Rom believes her findings point towards the important role of the disease — rather than effects of RA treatment.

However, the specific influence of various RA treatments needs further investigation as well.

Rom noted that research has shown an increased risk of epilepsy for people with autoimmune diseases such as multiple sclerosis, that directly involve the brain. However, rheumatoid arthritis does not directly affect the brain, yet has been found to increase the risk of epilepsy.

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.

Received March 13, 2016.
Accepted in final form August 10, 2016.

The study was supported by the U.S. National Institutes of Health, Danish Council for Independent Research and Augustinus Foundation.

To learn more about epilepsy, visit http://www.aan.com/patients.

The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with 30,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, LinkedIn and YouTube.

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Nov 23, 2016   Fetal Timeline   Maternal Timeline   News   News Archive   

Elisabeth Crank is a part-time North London police officer.
Her epilepsy only became apparent at 25.
After suffering a miscariage — possibly linked to her taking a low dose of carbamazepine — she decided
to not take any medication during her next pregnancy without telling anyone, not even her husband.
Image Credit: EpilepsyU.com


Phospholid by Wikipedia