Tu Yi-Fang, Wang Lan-Wan, Wang Shan-Tair, Yeh Tsu-Fu, Huang Chao-Ching
Department of Pediatrics, National Cheng Kung University Hospital, Institute of Clinical Medicine, and.
Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; and Departments of Pediatrics, College of Medicine, and.
Pediatrics. 2016 Apr;137(4). doi: 10.1542/peds.2015-3404. Epub 2016 Mar 24.
To investigate risk factors, seizure characteristics, and outcomes of febrile seizure (FS) in children born very preterm.
This study used a prospective registry data set of 844 preterm infants (birth weight <1500 g and gestational age <32 weeks) admitted to NICUs from 2001 to 2009 in southern Taiwan. We investigated the prevalence, risks, seizure patterns, and outcomes of FS in children aged 5 years.
Among 575 children (follow-up rate, 85.8%) followed up for 5 years, 35 (6.1%) developed FS. The FS and non-FS groups were comparable regarding their mean gestational age, birth weight, 5-minute Apgar score <6, and prenatal and postnatal complications. No difference was observed in the use of prenatal corticosteroids between the 2 groups. The FS group had a significantly higher rate of postnatal corticosteroid treatment than the non-FS group, even after adjusting for confounding factors (odds ratio, 5.4 [95% confidence interval, 1.9-15.8]; P = .006). No differences were observed in IQs or subsequent epilepsy rates between the 2 groups. Although no difference was observed in the age of FS onset or neurodevelopmental outcomes between the 2 groups, children with FS who received postnatal corticosteroid treatment had a significantly lower mean body temperature during the first FS attack compared with those who did not receive postnatal corticosteroid treatment (38.6 ± 0.4°C vs 39.2 ± 0.6°C; P = .034).
Children born very preterm have a higher rate of FS, and postnatal corticosteroid treatment was associated with FS susceptibility in these children.
探讨极早产儿热性惊厥（FS）的危险因素、惊厥特征及预后。
本研究使用了2001年至2009年台湾南部新生儿重症监护病房收治的844例早产儿（出生体重<1500g，胎龄<32周）的前瞻性登记数据集。我们调查了5岁儿童FS的患病率、风险、惊厥类型及预后。
在575例随访5年的儿童（随访率85.8%）中，35例（6.1%）发生了FS。FS组和非FS组在平均胎龄、出生体重、5分钟Apgar评分<6以及产前和产后并发症方面具有可比性。两组在产前使用糖皮质激素方面未观察到差异。即使在调整混杂因素后，FS组产后使用糖皮质激素治疗的比例仍显著高于非FS组（优势比，5.4[95%置信区间，1.9 - 15.8]；P = 0.006）。两组在智商或随后的癫痫发生率方面未观察到差异。虽然两组在FS发作年龄或神经发育结局方面未观察到差异，但与未接受产后糖皮质激素治疗的FS患儿相比，接受产后糖皮质激素治疗的FS患儿在首次FS发作时的平均体温显著更低（38.6±0.4°C对39.2±0.6°C；P = 0.034）。
极早产儿FS的发生率较高，产后糖皮质激素治疗与这些儿童的FS易感性有关。
