Sheth R D, Hobbs G R, Mullett M
Division of Pediatric Neurology, University of Wisconsin Medical School, Madison 53792-5132, USA.
J Perinatol. 1999 Jan;19(1):40-3. doi: 10.1038/sj.jp.7200107.
To examine the influence of gestational age on seizures in the neonatal intensive care unit.
A cohort of 4165 neonates admitted to a university intensive care unit between 1986 and 1995. The incidence, time of onset, and etiology of neonatal seizures in the cohort were distributed by gestational age. Logistic regression and t test were used to examine the relationship between gestational age and seizures in the neonatal intensive care unit.
Seizures occurred in 356 (8.6%) infants. The seizure rate was parabolically related to gestational age, such that infants at 30 to 36 weeks' gestation had a 4.8% rate compared with 11.9% and 14.1% rates for infants < 30 and > 36 weeks, respectively (p < 0.001). Seizures manifested earlier in infants < 30 weeks (2.3 +/- 5.6 days of life) and > 36 weeks (3.7 +/- 8.7 days) gestational age compared with neonates 30 to 36 weeks (10.4 +/- 14.5 days) (p < 0.001). Intraventricular hemorrhage was the principal etiology underlying the higher seizure rate for infants < 30 weeks (p < 0.001). Hypoxic-ischemic encephalopathy and congenital malformations were primary factors for infants > 36 weeks (p < 0.01). Nervous system infections were evenly distributed across gestational age.
Gestational age exerts a considerable influence on the incidence, onset, and etiology of neonatal seizures.
探讨胎龄对新生儿重症监护病房中癫痫发作的影响。
对1986年至1995年间入住某大学重症监护病房的4165例新生儿进行队列研究。该队列中新生儿癫痫发作的发生率、发作时间及病因按胎龄进行分布。采用逻辑回归和t检验来研究胎龄与新生儿重症监护病房中癫痫发作之间的关系。
356例（8.6%）婴儿发生了癫痫发作。癫痫发作率与胎龄呈抛物线关系，即孕30至36周的婴儿发作率为4.8%，而孕周<30周和>36周的婴儿发作率分别为11.9%和14.1%（p<0.001）。孕周<30周（出生后2.3±5.6天）和>36周（3.7±8.7天）的婴儿癫痫发作比孕30至36周的新生儿（10.4±14.5天）更早出现（p<0.001）。脑室内出血是孕周<30周婴儿癫痫发作率较高的主要病因（p<0.001）。缺氧缺血性脑病和先天性畸形是孕周>36周婴儿的主要因素（p<0.01）。神经系统感染在各胎龄间分布均匀。
胎龄对新生儿癫痫发作的发生率、发作时间及病因有相当大的影响。
