Akter Humayra, Dey Sanjoy Kumer, Shabuj Mohammad Kamrul Hassan, Fatema Kanij, Jahan Ismat, Sihan Nazmus, Rahman Tareq, Khan Md Abdullah Saeed, Hasan Mohammad Jahid
Department of Neonatology, Chittagong Medical College, Chattogram 4203, Bangladesh.
Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka 1000, Bangladesh.
Epilepsy Behav Rep. 2024 Apr 1;26:100665. doi: 10.1016/j.ebr.2024.100665. eCollection 2024.
Neonatal seizures can lead to long-term neurodevelopmental problems. This study aims to identify predictors of poor developmental outcomes in neonates with seizures to aid in early intervention and referral for follow-up and rehabilitation. This observational study was conducted in the Department of Neonatology and Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University. Among 75 study cases of neonatal seizure, 23 died, and 46 were followed-up at 6 and 9 months after discharge. EEGs were performed on every patient. A comprehensive neurological examination and developmental evaluation were performed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III). Three-fourths of neonates were born at term (76.1 %), and over half were male (56.5 %). The majority were appropriate for gestational age (79.7 %) and had an average birth weight of 2607 ± 696 g (±SD). Over half of the neonates (52.2 %) had adverse neurodevelopmental outcomes, with global developmental delay being the most common. Recurrent seizures, the number of anticonvulsants needed to control seizures, and abnormal Electroencephalograms were identified as independent predictors of adverse neurodevelopmental outcomes. The study highlights the need for early referral for follow-up and rehabilitation of neonates with seizures having abnormal electroencephalograms, recurrent seizures and requiring more anticonvulsants to control seizures.
新生儿惊厥可导致长期神经发育问题。本研究旨在确定惊厥新生儿发育不良结局的预测因素，以协助早期干预以及后续随访和康复转诊。这项观察性研究在班加班杜·谢赫·穆吉布医科大学新生儿科及儿童神经疾病与自闭症研究所开展。在75例新生儿惊厥研究病例中，23例死亡，46例在出院后6个月和9个月进行了随访。对每位患者均进行了脑电图检查。使用贝利婴幼儿发展量表第三版（贝利III）进行了全面的神经学检查和发育评估。四分之三的新生儿为足月儿（76.1%），半数以上为男性（56.5%）。大多数新生儿为适于胎龄儿（79.7%），平均出生体重为2607±696 g（±标准差）。半数以上的新生儿（52.2%）有不良神经发育结局，其中全球发育迟缓最为常见。反复惊厥、控制惊厥所需抗惊厥药物的数量以及脑电图异常被确定为不良神经发育结局的独立预测因素。该研究强调，对于脑电图异常、反复惊厥且需要更多抗惊厥药物来控制惊厥的惊厥新生儿，有必要尽早进行随访和康复转诊。
