Antiseizure prescription for children with severe congenital heart defects and children with gastrointestinal anomalies

Background
Children with congenital anomalies are at an increased risk of developing epilepsy, but the relative risk for specific anomaly subtypes remains underexplored. This study aims to estimate the risk of epilepsy, as indicated by antiseizure medication (ASM) prescriptions, among children with various congenital anomalies compared to children without anomalies.
Methods
We utilized data from six European regions participating in the EUROCAT registries, covering births from 2000 to 2015. Children with major congenital anomalies, classified by International Classification of Diseases (ICD) codes, were compared to a reference population without anomalies. Epilepsy was identified based on >1 ASM prescription within a year. Relative risks (RRs) were calculated using mixed-effects models to account for registry-specific variations.
Results
The study included 60,662 children with anomalies and 1,722,912 reference children, with a mean follow-up of 5.5 years. By age 5, ASM prevalence was 17.8 per 1,000 in anomaly groups and 2.0 per 1,000 in reference children. The highest RRs were observed in children with central nervous system (CNS) anomalies, including anomalies of the corpus callosum, severe microcephaly, and hydrocephalus. Comparable RRs were found in children with severe congenital heart defects (CHD) and gastrointestinal anomalies, primarily driven by diaphragmatic hernia.
Conclusion
Children with congenital anomalies have a significantly higher risk of epilepsy, with CNS, chromosomal, severe CHD, and diaphragmatic hernia being key contributors. This study highlights the importance of tailored monitoring and early intervention for high-risk groups to improve neurological outcomes.