Stephens Carol M, Proietti Jacopo, Mathieson Sean R, Livingstone Vicki, McNamara Brian, McSweeney Niamh, O'Mahony Olivia, Walsh Brian H, Murray Deirdre M, Boylan Geraldine B
INFANT Research Centre, University College Cork, Cork, Ireland.
Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
Epilepsia Open. 2025 Feb;10(1):155-167. doi: 10.1002/epi4.13089. Epub 2024 Dec 16.
To determine the incidence of later epilepsy in full-term infants with neonatal encephalopathy (NE) who undergo continuous electroencephalography (cEEG) monitoring in the neonatal period and to identify potential predictors of later epilepsy both in infants with and without electrographic neonatal seizures (ENS).
This was a retrospective observational study performed at Cork University Maternity Hospital, Cork, Ireland, between 2003 and 2019. All term infants with NE had a minimum of 2 h of cEEG monitoring in the neonatal period. ENS were identified via cEEG monitoring. Pediatric medical charts were reviewed to determine if epilepsy developed after the neonatal period and to determine potential predictors of epilepsy in infants both with and without ENS.
Two hundred and eighty infants were included. The overall incidence rate of epilepsy was 17.55 per 1000 person-years (95% CI: 10.91 to 28.23). In infants with ENS (n = 82), the incidence rate was 39.27 per 1000 person-years (95% CI: 22.30 to 69.16). In infants without ENS (n = 198), the incidence rate was 7.54 per 1000 person-years (95% CI: 3.14 to 18.12). The incidence rate was significantly higher in the ENS group compared to the non-ENS group (p-value = 0.002). Several potential predictors for the development of later epilepsy were identified including infants delivered vaginally, low Apgar scores at 1 and 5 min, severe HIE diagnosis, presence of ENS, a severely abnormal EEG background and an abnormal brain MRI.
Following NE, term infants are at risk of epilepsy with a significantly higher incidence rate in infants who experience ENS compared to those who did not. Close follow-up is required in both groups well into the childhood period.
This study aimed to determine the occurrence of epilepsy in children who were monitored for seizures in the newborn period. The occurrence of epilepsy was higher in infants who experienced seizures in the newborn period compared to those who did not. Several potential predictors of later epilepsy were identified in both groups of infants (those with and without seizures in the newborn period). Both groups of infants require close follow-up in childhood.
确定在新生儿期接受连续脑电图（cEEG）监测的足月新生儿脑病（NE）患儿中迟发性癫痫的发病率，并确定有和无脑电图新生儿惊厥（ENS）的患儿中迟发性癫痫的潜在预测因素。
这是一项于2003年至2019年在爱尔兰科克大学妇产医院进行的回顾性观察研究。所有患有NE的足月儿在新生儿期至少接受了2小时的cEEG监测。通过cEEG监测确定ENS。查阅儿科病历以确定新生儿期后是否发生癫痫，并确定有和无ENS的患儿中癫痫的潜在预测因素。
纳入了280名婴儿。癫痫的总体发病率为每1000人年17.55例（95%置信区间：10.91至28.23）。在有ENS的婴儿（n = 82）中，发病率为每1000人年39.27例（95%置信区间：22.30至69.16）。在无ENS的婴儿（n = 198）中，发病率为每1000人年7.54例（95%置信区间：3.14至18.12）。ENS组的发病率显著高于非ENS组（p值 = 0.002）。确定了几个迟发性癫痫发生的潜在预测因素，包括经阴道分娩的婴儿、1分钟和5分钟时阿氏评分低、重度缺氧缺血性脑病（HIE）诊断、ENS的存在、严重异常的脑电图背景和异常的脑部磁共振成像（MRI）。
患NE后，足月儿有癫痫风险，经历ENS的婴儿发病率明显高于未经历者。两组患儿在儿童期都需要密切随访。
本研究旨在确定在新生儿期接受癫痫监测的儿童中癫痫的发生情况。与未经历新生儿期癫痫发作的婴儿相比，经历新生儿期癫痫发作的婴儿癫痫发生率更高。在两组婴儿（新生儿期有和无癫痫发作的婴儿）中都确定了几个迟发性癫痫的潜在预测因素。两组婴儿在儿童期都需要密切随访。
