Department of Paediatrics, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India.
Department of Biochemistry, University College of Medical sciences and Guru Teg Bahadur Hospital, Delhi, India.
J Neonatal Perinatal Med. 2022;15(1):29-35. doi: 10.3233/NPM-200499.
Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors.
This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated.
Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57-2.84)], microcephaly [OR 5.93 (CI 0.55-64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18-30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43-14.78)], meningitis [OR 2.63(CI 0.08-6.39)], septicemia [OR1.22(CI 0.45-3.31)] and abnormal cranial USG [OR 7.95(CI 12.61-24.22)] were significant predictors of adverse outcomes in neonates with seizures.
Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.
新生儿癫痫是导致新生儿死亡和发病的重要原因。本研究旨在探讨新生儿癫痫不良结局的发生率，并确定其预测因素。
本观察性描述性研究纳入了 220 例癫痫发作的新生儿。排除了在检查前因疾病/死亡而夭折的新生儿，或母亲记录不完整的新生儿。所有患者均行血糖、血清钙、血清电解质和头颅超声检查。根据需要进行 CT 扫描、MRI 和先天性代谢缺陷谱检查。不良结局定义为死亡、苯巴比妥无反应或出院时检查异常。评估了新生儿癫痫的产前、围产期和新生儿预测因素。
220 例癫痫发作的新生儿中，76 例（34.5%）出现不良结局。极低出生体重儿（≤1500 克）[比值比（OR）1.27（95%可信区间 0.57-2.84）]、小头畸形[OR 5.93（95%可信区间 0.55-64.41）]、生后 5 分钟时 Apgar 评分≤3 分[OR 11.28（95%可信区间 14.18-30.45）]、发作起始时间在 24 小时内[OR 5.99（95%可信区间 12.43-14.78）]、脑膜炎[OR 2.63（95%可信区间 0.08-6.39）]、败血症[OR 1.22（95%可信区间 0.45-3.31）]和头颅超声异常[OR 7.95（95%可信区间 12.61-24.22）]是新生儿癫痫不良结局的显著预测因素。
早产、极低出生体重、出生窒息、脑膜炎、败血症和异常头颅超声可以预测新生儿癫痫的不良结局。改善产前和新生儿临床实践可能有助于减少这些患者的不良结局。
