Preterm infants with video-EEG confirmed seizures: outcome at 30 months of age

Brain Dev. 2008 Jan;30(1):20-30. doi: 10.1016/j.braindev.2007.05.003. Epub 2007 Oct 26.


Objective: Our aim was to identify early predictors of poor neurodevelopmental outcome and of subsequent epilepsy in very early preterm and late preterm newborns with neonatal seizures.

Study design: Fifty-one preterm infants with gestational age (GA) <or=36 weeks were identified among those admitted to the NICU of University Hospital of Parma between January 1999 and December 2003 and prospectively followed-up. They were subdivided in two Groups: early preterm newborns with a GA <or=29 weeks and those with GA between 30 and 36 weeks. Selection criteria included multiple digital-video-EEG confirmed neonatal seizures and a follow-up of at least 30 months. Independent variables considered for analysis included neonatal risk factors, etiology and type of seizures, EEG activity, and cerebral ultrasound scan examinations.

Results: Ten infants had a favorable outcome, 17 died, and 23 had an adverse outcome. One infant was lost on follow-up. Apgar score at 1 min (O.R.=15.457, 95% CI: 2.236-106.850, p=0.006) and severely abnormal background EEG activity (O.R.=8.298, 95% CI: 1.316-52.301, p=0.024) were independent predictors of abnormal outcome. Nine infants presented post-neonatal epilepsy. Severely abnormal Cerebral Ultrasound scans were predictive of epilepsy (O.R.=13.72, 95% CI: 1.959-96.149, p=0.008).

Conclusions: Neonatal seizures in preterm infants are associated to a high rate of mortality and severe morbidity in survivors but no definitive differences between the two groups of preterm infants were found. Risk-factors for development of subsequent epilepsy are strongly related to the underlying brain damage.

MeSH terms

  • Age of Onset
  • Apgar Score
  • Brain Damage, Chronic / mortality
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology
  • Child, Preschool
  • Comorbidity
  • Developmental Disabilities / mortality
  • Electroencephalography / methods*
  • Epilepsy / diagnostic imaging*
  • Epilepsy / mortality*
  • Epilepsy / physiopathology
  • Epilepsy, Benign Neonatal / diagnostic imaging*
  • Epilepsy, Benign Neonatal / mortality*
  • Epilepsy, Benign Neonatal / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant
  • Infant Mortality / trends
  • Infant, Newborn
  • Male
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Ultrasonography
  • Video Recording / methods*