Early electrographic seizures, brain injury, and neurodevelopmental risk in the very preterm infant

Early electrographic seizures, brain injury, and neurodevelopmental risk in the very preterm infant

Background: Previous studies of very preterm (VPT) infants have shown a wide range of seizure prevalence and association with intraventricular hemorrhage (IVH), white matter injury (WMI), and death. However, the impact of seizures on neurodevelopment is not well known. We hypothesized that seizures...

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Bibliographic Details
Published in:Pediatric research Vol. 75; no. 4; pp. 564 - 569
Main Authors: Vesoulis, Zachary A., Inder, Terrie E., Woodward, Lianne J., Buse, Bradley, Vavasseur, Claudine, Mathur, Amit M.
Format: Journal Article
Language:English
Published: New York Nature Publishing Group US 01-04-2014
Subjects:
692/699/375/178
692/699/375/2764
692/700/1720/3185
Brain Injuries - physiopathology
clinical-investigation
Electroencephalography
Female
Humans
Infant, Newborn
Infant, Premature
Male
Medicine & Public Health
Pediatric Surgery
Pediatrics
Risk Factors
Seizures - physiopathology
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Summary:Background: Previous studies of very preterm (VPT) infants have shown a wide range of seizure prevalence and association with intraventricular hemorrhage (IVH), white matter injury (WMI), and death. However, the impact of seizures on neurodevelopment is not well known. We hypothesized that seizures in the first 3 d after VPT birth would be associated with increased radiographic brain injury and later neurodevelopmental risk. Methods: For 72 h after birth, 95 VPT infants underwent amplitude-integrated electroencephalogram monitoring. High and low seizure burdens were related to radiographic brain injury, death in the neonatal period, and children’s Bayley III ( Bayley Scales of Infant Development ) performance at 2 y corrected age in a subgroup of 59 infants. Results: The overall incidence of seizures in this sample was 48%. High seizure burden was associated with increased risk of IVH on day 1; IVH, WMI, and death on day 2; and high-grade IVH on day 3. The presence of seizures on any day was associated with decreased language performance at age 2, even after controlling for family social risk. Conclusion: Seizures during the first 3 d after birth are common and are associated with an increased risk of IVH, WMI, and death. They were also associated with poorer early language development.
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ISSN:0031-3998
1530-0447
DOI:10.1038/pr.2013.245