Introduction.
Studies reported an increased risk for epilepsy in children exposed to antibiotics prenatally. A pathophysiologic mechanism seemed improbable and required adjustment for confounders.
Methods.
In a retrospective cohort investigation we enrolled children aged 1 to 18 years born between 1998 and 2012 at the Soroka Medical Center and their mothers members of "Clalit" Heath Services. Exposed group included children whose mothers purchased one or more antibiotic medications during pregnancy. Computerized medications database was linked with hospital records of mothers and their children. Epilepsy was defined by "Epilepsy" diagnosis and or by dispensing of antiepileptic drugs. After applying inclusion and exclusion criteria, 88,899 children and their 74,416 mothers were selected.
Results.
The group exposed prenatally to antibiotics comprised 33,622 children (or 41.2%). Of them 326 (0.9%) developed epilepsy compared to 370 (0.7%) in the unexposed group (p=0.002). Based on a multivariate analysis, exposure during the first, second and third trimester of pregnancy was characterized by incidence of epilepsy in 0.8% (p=0.935), 0.9% (p=0.092) and 0.9% (p=0.016) of the children respectively. By Poisson regression analysis epilepsy was statistically associated with male sex, maternal smoking and delivery by cesarean section. The possibility of confounding by indication was refuted.
Conclusion.
We found that intrauterine exposure to antibiotics is associated with development of epilepsy in children. Possible pathophysiological mechanisms will be discussed.
