Babies born to overweight or obese mothers have a greater chance of developing childhood epilepsy, a huge study of more than a million births in Sweden has shown.
The study was recently published online in JAMA Neurology. Neda Razaz of the Karolinska Institute, Stockholm examined 1.4 million live births between 1992 and 2011 to determine epilepsy incidence as those babies aged from 28 days to 16 years.
The greater a mother’s body mass index, the greater the risk of having a baby that developed childhood epilepsy.
Grade III obesity — mothers with a BMI of 40 or more — was associated with an 82 percent increased risk of epilepsy. For moms with BMIs of 30 to 35, the increased risk was 20 percent. For those with grade II obesity — BMIs of 35 to 39 — the increased risk was 30 percent.
“Limitations of the study include possible misclassification and underreporting in some of the data, as well as an acknowledgement that the cause of epilepsy may be multidimensional, with interaction between genetic and environmental factors,” JAMA reported in a news release.
“Given that overweight and obesity are modifiable, prevention of obesity may be an important public health strategy to reduce the incidence of childhood obesity,” the authors concluded.
In an accompanying editorial, Dr. William Bell of The Ohio State University Wexner Medical Center, Columbus lists the many dangers of having a baby while obese. “Infants born to overweight and obese women are more likely to have congenital abnormalities, especially cardiac and neural tube defects, an increased risk of being transferred to a neonatal intensive care unit, and being large for gestational age,” Bell explains.
The work by Razaz et al. showed that neonatal seizures among their sample increased proportionately to the mother’s weight, “such that obesity grade III quadrupled the risk of neonatal seizures.”
Bell explained that “obesity and pregnancy combined to result in a chronic inflammatory state. This state, along with genetic factors, may create an abnormal intrauterine environment…”
Bell noted that a meta-analysis comparing metformin with insulin treatment for women with gestational diabetes showed metformin “to be superior in limiting weight gain as well as reducing pregnancy-induced hypertension…”
However, a randomized metformin trial in obese and overweight women “did not show a difference in maternal or fetal outcomes,” Bell wrote. “Prevention of overweight and obesity with caloric reduction and physical activity in pregnant women appears to be the safest alternative.”
He called for more research into this topic, specifically “large, population-based cohort studies.” “There needs to be a better assessment of the risk of childhood-onset epilepsy in the offspring of obese mothers with epilepsy,” he concluded.