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Predictors of Adverse Outcomes in Neonates with Seizures

Received: 23 June 2022    Accepted: 9 July 2022    Published: 20 July 2022
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Abstract

Background: Seizures in neonatal period could generate long-term neurodevelopmental impairment; therefore, explicit clarification of adverse outcome predictors should direct the ongoing and subsequent treatment plan. Objective: The study aimed to address predictors of adverse neurodevelopmental outcomes and/or mortality of full-term infants who developed neonatal seizures. Methods: This longitudinal prospective cohort study was conducted from 2019 to 2021 in tertiary hospital, Egypt and included the full-term infants till 18 months of age after occurrence of clinical/electrical seizures in neonatal period and healthy infants of matched age and sex. All infants were assessed by Bayley-III developmental scales in three main domains (cognitive, language and motor). The required data for the predictive factors of adverse outcome had been registered on REDCap tools and exported for statistical analysis. Results: Sixty four infants were enrolled (35 developed seizures and 29 were healthy), 29% died. There were significant group differences (better results were in favor of healthy infants) in the need for initial resuscitation, 1st and 5th minute APGAR score and in all developmental domains. Medium correlation was found between abnormal motor subscale and multiple attacks of seizures, the need for anti-seizure medication on discharge and low 5th minute APGAR score. Time to death was significant earlier in infants required initial resuscitation, developed seizures within 1st day of life with special characteristics (as exceeding 6 days with abnormal aEEG background, >2 anti-epileptic drugs were prescribed for optimum control and also were prescribed on their discharge plan) and also those exceeded 19 days admission in NICU. Conclusion: Occurrence of seizures in neonatal period had its unique signature on long-term morbidity. Early death and abnormal motor domain in later life could be predicted from the 1st days of birth though low APGAR score, frequency and duration of seizures, EEG background and the need for anti-seizure medication on discharge.

Published in American Journal of Pediatrics (Volume 8, Issue 3)
DOI 10.11648/j.ajp.20220803.12
Page(s) 158-167
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

APGAR Score, Cognitive, Language, Seizures

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Cite This Article
  • APA Style

    Menna Ebrahim Hashish, Ahmad Darwish, Mohamed Reda Bassiouny. (2022). Predictors of Adverse Outcomes in Neonates with Seizures. American Journal of Pediatrics, 8(3), 158-167. https://doi.org/10.11648/j.ajp.20220803.12

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    ACS Style

    Menna Ebrahim Hashish; Ahmad Darwish; Mohamed Reda Bassiouny. Predictors of Adverse Outcomes in Neonates with Seizures. Am. J. Pediatr. 2022, 8(3), 158-167. doi: 10.11648/j.ajp.20220803.12

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    AMA Style

    Menna Ebrahim Hashish, Ahmad Darwish, Mohamed Reda Bassiouny. Predictors of Adverse Outcomes in Neonates with Seizures. Am J Pediatr. 2022;8(3):158-167. doi: 10.11648/j.ajp.20220803.12

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  • @article{10.11648/j.ajp.20220803.12,
      author = {Menna Ebrahim Hashish and Ahmad Darwish and Mohamed Reda Bassiouny},
      title = {Predictors of Adverse Outcomes in Neonates with Seizures},
      journal = {American Journal of Pediatrics},
      volume = {8},
      number = {3},
      pages = {158-167},
      doi = {10.11648/j.ajp.20220803.12},
      url = {https://doi.org/10.11648/j.ajp.20220803.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220803.12},
      abstract = {Background: Seizures in neonatal period could generate long-term neurodevelopmental impairment; therefore, explicit clarification of adverse outcome predictors should direct the ongoing and subsequent treatment plan. Objective: The study aimed to address predictors of adverse neurodevelopmental outcomes and/or mortality of full-term infants who developed neonatal seizures. Methods: This longitudinal prospective cohort study was conducted from 2019 to 2021 in tertiary hospital, Egypt and included the full-term infants till 18 months of age after occurrence of clinical/electrical seizures in neonatal period and healthy infants of matched age and sex. All infants were assessed by Bayley-III developmental scales in three main domains (cognitive, language and motor). The required data for the predictive factors of adverse outcome had been registered on REDCap tools and exported for statistical analysis. Results: Sixty four infants were enrolled (35 developed seizures and 29 were healthy), 29% died. There were significant group differences (better results were in favor of healthy infants) in the need for initial resuscitation, 1st and 5th minute APGAR score and in all developmental domains. Medium correlation was found between abnormal motor subscale and multiple attacks of seizures, the need for anti-seizure medication on discharge and low 5th minute APGAR score. Time to death was significant earlier in infants required initial resuscitation, developed seizures within 1st day of life with special characteristics (as exceeding 6 days with abnormal aEEG background, >2 anti-epileptic drugs were prescribed for optimum control and also were prescribed on their discharge plan) and also those exceeded 19 days admission in NICU. Conclusion: Occurrence of seizures in neonatal period had its unique signature on long-term morbidity. Early death and abnormal motor domain in later life could be predicted from the 1st days of birth though low APGAR score, frequency and duration of seizures, EEG background and the need for anti-seizure medication on discharge.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Predictors of Adverse Outcomes in Neonates with Seizures
    AU  - Menna Ebrahim Hashish
    AU  - Ahmad Darwish
    AU  - Mohamed Reda Bassiouny
    Y1  - 2022/07/20
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ajp.20220803.12
    DO  - 10.11648/j.ajp.20220803.12
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 158
    EP  - 167
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20220803.12
    AB  - Background: Seizures in neonatal period could generate long-term neurodevelopmental impairment; therefore, explicit clarification of adverse outcome predictors should direct the ongoing and subsequent treatment plan. Objective: The study aimed to address predictors of adverse neurodevelopmental outcomes and/or mortality of full-term infants who developed neonatal seizures. Methods: This longitudinal prospective cohort study was conducted from 2019 to 2021 in tertiary hospital, Egypt and included the full-term infants till 18 months of age after occurrence of clinical/electrical seizures in neonatal period and healthy infants of matched age and sex. All infants were assessed by Bayley-III developmental scales in three main domains (cognitive, language and motor). The required data for the predictive factors of adverse outcome had been registered on REDCap tools and exported for statistical analysis. Results: Sixty four infants were enrolled (35 developed seizures and 29 were healthy), 29% died. There were significant group differences (better results were in favor of healthy infants) in the need for initial resuscitation, 1st and 5th minute APGAR score and in all developmental domains. Medium correlation was found between abnormal motor subscale and multiple attacks of seizures, the need for anti-seizure medication on discharge and low 5th minute APGAR score. Time to death was significant earlier in infants required initial resuscitation, developed seizures within 1st day of life with special characteristics (as exceeding 6 days with abnormal aEEG background, >2 anti-epileptic drugs were prescribed for optimum control and also were prescribed on their discharge plan) and also those exceeded 19 days admission in NICU. Conclusion: Occurrence of seizures in neonatal period had its unique signature on long-term morbidity. Early death and abnormal motor domain in later life could be predicted from the 1st days of birth though low APGAR score, frequency and duration of seizures, EEG background and the need for anti-seizure medication on discharge.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt

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