Relationship between interpregnancy interval and birth defects in Washington State.

OBJECTIVE: Interpregnancy interval (IPI) influences numerous adverse perinatal outcomes. IPI's impact on birth defects is unclear. STUDY DESIGN: We conducted a population-based case-control study, using 1998 to 2008 administrative data from Washington State. A total of 10, 772 cases, women whose second of two births resulted in an infant with a birth defect, were compared with 32 ,310 controls, women whose second of two births did not result in an infant with a birth defect. RESULT: Compared with mothers with an IPI between 18 to 23 months, those with an IPI <6 months or ≥60 months had elevated risks of delivering an infant with a birth defect (odds ratio=1.15, 95% confidence interval: 1.03 to 1.28, and odds ratio=1.15, 95% confidence interval: 1.04 to 1.26, respectively). CONCLUSION: We observed a J-shaped relationship between IPI and risk of having an infant with a birth defect. As this is one of the first studies to evaluate this association, confirmatory studies are needed.

Neurocysticercosis: association between seizures, serology, and brain CT in rural Peru.

BACKGROUND: Neurocysticercosis (NCC) is the commonest helminthic CNS infection and the main cause of adult-onset seizures in developing countries, also frequent in industrialized countries because of immigration from endemic zones. Although NCC is commonly seen in individuals with seizures in endemic areas, its role as a cause of epilepsy has been questioned on the basis of the poor methodology of published studies. OBJECTIVE: To determine, in a cysticercosis-endemic area of the northern Peruvian coast, the frequency of 1) epileptic seizures, 2) serum antibodies to Taenia solium, 3) NCC-compatible findings on brain CT, and 4) the associations between these variables. METHODS: A community-wide screening survey for possible seizure cases was performed using a validated questionnaire. Positive respondents were later examined in the field by neurologists. Seizure cases were categorized as single seizure, active epilepsy, or inactive epilepsy. Serology was performed for all consenting individuals using immunoblot. Noncontrast brain CT scans were performed in all individuals with seizures and two groups of control subjects without seizures (seropositive and seronegative). RESULTS: The screening survey was applied to 903 permanent residents. Most positive respondents (114/137 [83.2%]) were examined by neurologists. The overall prevalence of epilepsy was 32.1 per 1,000 and that of active epilepsy was 16.6 per 1,000. Seroprevalence was 24.2% (200/825). Seroprevalence was associated with seizures (odds ratio 2.14; p = 0.026). Brain CT abnormalities compatible with NCC were more frequent in individuals with seizures and in those seropositive. CONCLUSION: In this hyperendemic area, an important proportion of seizure cases are associated with neurocysticercosis as demonstrated by serology or brain CT.