Date of Award

January 2024

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Zeyan Liew

Second Advisor

Tormod Rogne


AbstractBackground and aims: Epilepsy is one of the most common neurologic disorders in childhood, but the etiology for the majority of the cases remains unknown. As a modifiable trait in pregnancy, gestational weight gain (GWG) has been shown to be a risk factor for multiple adverse birth outcomes. This study aims to investigate whether non-optimal GWG is associated with the risk of epilepsy in the offspring using a linked database in California. Methods: A population-based cohort study was conducted using the linked database from the Birth Certificate Record in California (2007-2015) for GWG, and the diagnostic records of epilepsy from the California Department of Development Services (DDS; 2007-2021). Logistic regression models were performed to estimate the crude and adjusted Odds Ratio (OR) and 95% confidence interval (CI) between pre-pregnancy body mass index (BMI) or non-optimal GWG and the risk of epilepsy in the offspring. For non-optimal GWG, we examined weight loss, and insufficient or excessive weight gain, using the Institute of Medicine 2009 standard. Results: Maternal pre-pregnancy overweight (25<=BMI<30 kg/m2) or obesity (BMI>=30 kg/m2) were associated with increased risk of childhood epilepsy (Overweight: OR: 1.12, 95% CI: 1.03-1.22; Obesity: OR: 1.31, 95% CI: 1.20-1.43). A subset of obese mothers who experienced gestational weight loss was associated with an increased risk of childhood epilepsy (OR: 1.35, 95% CI: 1.03-1.77), but overall, insufficient or excessive weight gain during pregnancy was not associated with epilepsy in the offspring. Conclusion: Maternal pre-pregnancy overweight and obesity, but not non-optimal GWG, were associated with childhood epilepsy risk in California. The findings regarding gestational weight loss among obese women need further confirmation.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/07/2025