Gebremariam Ayele, Gutema Yoseph, Leuel Abadi, Fekadu Habtamu
Department of Pediatrics and Child Health, Medical Faculty, Addis Ababa University, Ethiopia.
Ann Trop Paediatr. 2006 Jun;26(2):127-31. doi: 10.1179/146532806X107476.
In a large majority of term newborns, early-onset neonatal seizures (EONS) are believed to relate to perinatal risk factors.
To identify risk factors for EONS.
Among a cohort of 1293 newborns admitted over a period of 2 years to the neonatal intensive care unit of Tikur Anbasa Hospital, Addis Ababa, 93 had seizures. The case control study method was used to identify risk factors associated with EONS. Univariate analysis was used to further examine risk factors after adjusting for the effect of severe perinatal asphyxia (Apgar < or = 3).
A total of 78 (85%) term newborns had EONS. Hypoxic-ischaemic encephalopathy (OR 3.46, 95% CI 2.74-7.42) and shock (OR 2.53, 95% CI 1.51-4.76) were significantly associated with EONS. Multifocal clonic (66%) followed by focal clonic (22%) were the most common types of EONS. Nine (11%) of the newborns with EONS died. During follow-up, 37 (53%) of the 69 surviving newborns with EONS had psychomotor delay with or without neurological deficit.
Hypoxic-ischaemic encephalopathy and shock are important causes of EONS.
在绝大多数足月儿中，早发性新生儿惊厥（EONS）被认为与围产期危险因素有关。
确定EONS的危险因素。
在亚的斯亚贝巴提库尔·安巴萨医院新生儿重症监护病房2年期间收治的1293例新生儿队列中，93例发生惊厥。采用病例对照研究方法确定与EONS相关的危险因素。在调整严重围产期窒息（阿氏评分≤3分）的影响后，采用单因素分析进一步检查危险因素。
共有78例（85%）足月儿发生EONS。缺氧缺血性脑病（比值比3.46，95%可信区间2.74 - 7.42）和休克（比值比2.53，95%可信区间1.51 - 4.76）与EONS显著相关。多灶性阵挛（66%）其次是局灶性阵挛（22%）是EONS最常见的类型。9例（11%）发生EONS的新生儿死亡。随访期间，69例存活的EONS新生儿中有37例（53%）有精神运动发育迟缓，伴或不伴有神经功能缺损。
缺氧缺血性脑病和休克是EONS的重要病因。
