Evidence map›Paper›PMID 41689071›Full record

ArticleBMC medicine2026

Intrauterine exposure to maternal diabetes and the risk of developing epilepsy in children: a national cohort study of 2.3 million children.

Muhammad Zakir Hossin, Martina Persson, Marte-Helene Bjørk, Olof Stephansson, Neda Razaz

Abstract read
In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Muhammad Zakir HossinDepartment of Medicine, Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, SE-171 76, Sweden. zakir.hossin@ki.se.ORCID 0000-0002-9078-419X
Martina PerssonDepartment of Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden.
Marte-Helene BjørkDepartment of Clinical Medicine, University of Bergen, Bergen, Norway.
Olof StephanssonDepartment of Medicine, Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, SE-171 76, Sweden.
Neda RazazDepartment of Medicine, Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, SE-171 76, Sweden.

Funding

Forskningsrådet för hälsa, arbetsliv och välfärd 2023-00492Forskningsrådet för hälsa, arbetsliv och välfärd 2023-01238Hjärt-Lungfonden 3581/2020South Africa-Sweden University Forum 31004392The Stockholm County Council, ALF Medicine 501143Vetenskapsrådet 2979/2020
6 · The paper itself

Abstract

backgroundApproximately half of the epilepsy cases lack a documented cause. Despite growing evidence linking maternal diabetes to pregnancy complications and impaired child neurodevelopment, little is known about its potential association with child epilepsy. This study aims to determine whether intrauterine exposure to maternal pre-existing type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), or gestational diabetes mellitus (GDM) increases the risk of epilepsy in children.

methodsThis study included live-born children without major malformations in Sweden from 1998 to 2021. Children were followed from birth until epilepsy diagnosis, death, emigration, or October 2023. Child epilepsy, maternal T1DM, T2DM, GDM, and a comprehensive set of covariates were identified through linked national health registers. Multivariable Cox proportional hazards regression was used to examine the association between maternal diabetes and child epilepsy, estimating adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Analyses also included paternal T1DM and T2DM as negative control exposures to assess potential genetic confounding. Preeclampsia, preterm birth, and birth asphyxia were evaluated as mediators, using a sequential mediation approach.

resultsOf the 2,305,051 children, 14,283 (0.6%) were exposed to maternal T1DM, 3,833 (0.2%) to T2DM, and 36,388 (1.6%) to GDM. Over a median follow-up of 13 years (range 0 to 25.8 years), 18,968 were diagnosed with epilepsy, corresponding to an incidence rate of 63.7 per 100,000 person-years. Compared with no maternal diabetes, maternal T1DM and T2DM were associated with increased hazards of epilepsy in children, with aHRs of 1.30 (95% CI 1.11-1.52) and 1.41 (95% CI 1.01-1.97), respectively. Preterm birth and birth asphyxia jointly mediated nearly half of the total effect of T1DM (HR

conclusionsIn this large cohort study, maternal T1DM and T2DM were associated with an increased risk of epilepsy in children. These associations are likely influenced by intrauterine mechanisms and were partially mediated by preterm birth and asphyxia-related conditions at birth.

Indexed as

Diabetes, GestationalDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2EpilepsyPregnancy in DiabeticsPrenatal Exposure Delayed EffectsAdultChildChild, PreschoolCohort StudiesFemaleHumansInfantInfant, NewbornMalePregnancyEpilepsyGestational diabetesNegative-controlSequential mediationType 1 diabetesType 2 diabetes

Identifiers

PMID41689071
PMCPMC12930888

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.