Which child will have a febrile seizure?
P. Bethune, K. Gordon, J. Dooley, C. Camfield and P. Camfield
Izaak Walton Killam Children's Hospital, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.
OBJECTIVE--To identify risk factors predictive of a first febrile seizure.
DESIGN--Case-control study. SETTING--Regional referral pediatric hospital
emergency department. PATIENTS--Seventy-five patients aged 6 months to 4
years presenting with a first febrile seizure were age-matched to two
febrile and two afebrile noninfectious controls who had never had a
seizure. METHODS--Telephone interview of parents. MAIN OUTCOME
MEASURES--Risk factors assessed included family history of febrile or
afebrile seizures, neurodevelopmental abnormality, and child-care
arrangement. Analysis was done by matched case-control and logistic
regression. RESULTS--Factors associated with a significant increase in risk
of a first febrile seizure were febrile seizures in first-degree relative
(odds ratio [OR], 4.5) or second-degree relative (OR, 3.5); neonatal
discharge at 28 days or later (OR, 5.6); parental report of "slow"
development (OR, 4.9); and day-care attendance (OR, 3.1). For children with
two risk factors (an estimated 3% of the population), the risk of
developing febrile seizures is approximately 28% (assuming a population
incidence of febrile seizures of 4%).
