Early-onset neonatal sepsis ups risk of childhood epilepsy

Infants who contract an invasive bacterial infection during the first week of life have double the risk of epilepsy in childhood, according to a register-based cohort study from Denmark.

Researchers identified all Danish live-born singletons who had at least 35 completed gestational weeks at birth and had no major congenital anomalies and who were born between 1997 and 2013 and followed up until 2021 or age 18 years, whichever came first.

A total of 981,869 children (median gestational age 40 weeks, 51 percent male) were included in the analysis. Of these children, 8,154 (0.8 percent) had sepsis and 152 (<0.1 percent) had meningitis, with 257 and 32 children having culture-positive infections, respectively. Sepsis and meningitis were defined as an invasive bacterial infection during the first week of life.

Epilepsy occurred at a rate of 1.6 per 1,000 person-years among children who had sepsis as opposed to 0.9 per 1,000 person-years among those without an infection. In multivariable Cox regression models, sepsis was associated with an 85-percent increased risk of childhood epilepsy (adjusted hazard ratio [HR], 1.85, 95 percent confidence interval [CI], 1.60–2.13).

Culture-positive sepsis was also associated with an increased risk of childhood epilepsy (incidence rate ratio [IRR], 2.70, 95 percent CI, 1.08–5.56), with the highest risk observed in children with meningitis both diagnosed (IRR, 9.85, 95 percent CI, 5.52–16.27) and verified by culture (IRR, 16.04, 95 percent CI, 5.21–37.46).