Exploring the risk factors for vaccine-associated and non-vaccine associated febrile seizures in a large pediatric cohort.

摘要: Abstract Introduction It is not known whether there are underlying physiologic or immunologic differences between febrile seizures (FS) triggered by vaccines versus other causes. Furthermore, while secular and individual-level factors have been associated with FS risk, they rarely evaluated simultaneously. Methods Subjects included members of Kaiser Permanente Southern California aged 6 months to 3 years from July 1, 2003–December 31, 2011. Primary outcome was first diagnosis FS. Vaccine-associated (VA) were defined as those occurring day 0 15 following any vaccine; non-vaccine (NVA) outside this period. We compared incidence rates VA-FS NVA-FS. Poisson regression used assess the association factors. also interactions vaccine exposure each model covariate on risk Results Among 265,275 children, 3348 identified; 383(11%) VA-FS, 2965(89%) Incidence 2.73 2.05 per 100,000 person-days for NVA-FS, respectively. Multivariable analyses confirmed previously reported increased age, low gestational winter months. Increased VA (RR = 1.63[95% CI: 1.27–2.11]), non-White race/ethnicity vs. White (African-American RR = 1.41[1.22–1.63]; Asian RR = 1.58[1.40–1.79]; Hispanic RR = 1.60[1.47–1.75]), maternal age 29 less 40+ (≤19 RR = 1.28[1.00–1.65]; 20–29 RR = 1.21[1.02–1.42]). Females at lower NVA-FS (RR = 0.77[0.72–0.83]), but similar males (RR = 0.97[0.79–1.19]). Children 1 min Apgar scores (≤3) had (RR = 3.40[1.86–6.22]), no (RR = 1.05[0.69–1.60]) children normal (≥7). Discussion This study suggests that may be immunogenetic VA-FSs FSs. However, further studies needed. An understanding mechanisms behind these findings help improve design policies.