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

Damkjaer, Mads; Morris, Joan K; Ballardini, Elisa; Barrachina-Bonet, Laia; Cavero-Carbonell, Clara; Coi, Alessio; Gissler, Mika; ... Loane, Maria; + view all (2026) Antiseizure prescription for children with severe congenital heart defects and children with gastrointestinal anomalies. Pediatric Neurology 10.1016/j.pediatrneurol.2026.01.003. (In press). Green open access

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Abstract

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.

Type: Article
Title: Antiseizure prescription for children with severe congenital heart defects and children with gastrointestinal anomalies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.pediatrneurol.2026.01.003
Publisher version: https://doi.org/10.1016/j.pediatrneurol.2026.01.00...
Language: English
Additional information: This version is the author accepted manuscript. It has been made open access under the Creative Commons (CC BY) licence under the terms of the UCL Intellectual Property (IP) Policy and UCL Publications Policy.
Keywords: Congenital anomalies, Epilepsy, Antiseizure medication, EUROCAT, Pediatric neurology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10220658
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