Hosseinzadeh Shima, Vagharmousavi Dorsa, Rajabzadeh Rezvan, Bayani Ghasem, Babaei Meisam
School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Epidemiologist, Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Iran J Child Neurol. 2025 Jun 25;19(3):53-62. doi: 10.22037/ijcn.v19i3.46506. eCollection 2025 Summer.
Identifying neonates at risk for hypoglycemia and establishing treatment protocols to prevent potential neurological complications are essential. This study aims to investigate the possible risk factors for epilepsy in children with a history of neonatal hypoglycemia in North Khorasan Province.
MATERIALS & METHODS: This case-control study analyzed 64 children with a previous history of neonatal hypoglycemia between 2017 and 2021 in North Khorasan Province. Nineteen children with epilepsy were selected as the case group, and their MRI data were extracted from medical records. In the control group (45 individuals who did not develop epilepsy), children were randomly selected, and their data were also collected. The researchers completed the ages and stages questionnaire (ASQ) for both case and control groups at follow-up. Pregnancy, delivery, and neonatal health information was obtained from hospital records using a checklist. Statistical analysis was performed using SPSS v20, with data entry and coding accuracy ensured before analysis.
This case-control study was conducted on 64 children (19 with epilepsy and 45 without epilepsy) with neonatal hypoglycemia. The mean age for the case and control groups were 4.1 and 4.6 years, respectively. An association was observed between epilepsy prevalence (58%) and familial history (p<0.05). Children who developed epilepsy had more extended periods of hypoglycemia and NICU stays (p<0.05). The age when hypoglycemia starts has a significant impact on the development of epilepsy, with an eight times higher risk for every extra day of life at the time of hypoglycemia (p<0.05). The ASQ findings revealed significant deficiencies between case and control groups (p<0.05). MRI results demonstrated that ~82% of children with epilepsy displayed irregularities, predominantly gliosis, and encephalomalacia in the occipital area (abnormal pathologic findings).
Neonatal hypoglycemia significantly raises the likelihood of developing epilepsy in later childhood. This risk is particularly high when the newborn requires an extended stay in the NICU, experiences delayed onset of hypoglycemia, or has a family history of epilepsy. Prompt recognition and focused intervention for newborns with these risk factors are essential to minimize the chances of developing epilepsy and related neurodevelopmental issues.
识别有低血糖风险的新生儿并制定治疗方案以预防潜在的神经并发症至关重要。本研究旨在调查霍拉桑省北部有新生儿低血糖病史儿童癫痫的可能危险因素。
本病例对照研究分析了2017年至2021年期间霍拉桑省北部64例有新生儿低血糖病史的儿童。选择19例癫痫患儿作为病例组，从病历中提取其MRI数据。在对照组（45例未患癫痫的个体）中，随机选取儿童并收集其数据。研究人员在随访时为病例组和对照组完成了年龄与发育进程问卷（ASQ）。使用检查表从医院记录中获取妊娠、分娩和新生儿健康信息。使用SPSS v20进行统计分析，在分析前确保数据录入和编码的准确性。
本病例对照研究对64例有新生儿低血糖的儿童（19例患癫痫，45例未患癫痫）进行了研究。病例组和对照组的平均年龄分别为4.1岁和4.6岁。观察到癫痫患病率（58%）与家族史之间存在关联（p<0.05）。患癫痫的儿童低血糖持续时间和新生儿重症监护病房（NICU）住院时间更长（p<0.05）。低血糖开始时的年龄对癫痫的发生有显著影响，低血糖发生时每多一天生命，患癫痫的风险就高出八倍（p<0.05）。ASQ结果显示病例组和对照组之间存在显著差异（p<0.05）。MRI结果表明，约82%的癫痫患儿存在异常，主要是枕叶区域的胶质增生和脑软化（异常病理表现）。
新生儿低血糖显著增加了儿童后期患癫痫的可能性。当新生儿需要在NICU长时间住院、低血糖发作延迟或有癫痫家族史时，这种风险尤其高。对有这些危险因素的新生儿进行及时识别和针对性干预对于将患癫痫及相关神经发育问题的几率降至最低至关重要。
