title: Factors predictive of seizures and neurologic outcome in perinatal depression.
abstract: To identify which early clinical variables are predictive of outcome in newborns with perinatal depression, we prospectively examined newborns with persistently abnormal neurologic examinations at 48 hours and (1) arterial pH </= 7.15, (2) 5-minute Apgar </= 5, (3) requirement for positive pressure ventilation in the delivery room, or (4) fetal heart rate monitoring abnormalities. Eighty-four such infants completed neurodevelopmental assessment at 1 year. Five-minute Apgar (P = 0.0064), arterial pH (P = 0.0065) and base excess (P = 0.0003), neonatal encephalopathy grade at 48 hours and 7 days (both P = 0.0001), EEG at 48 hours and 7 days (both P = 0.0001), cranial ultrasound (US) at 48 hours (P = 0.0013) and 7 days (P = 0.0002), and the occurrence of neonatal seizures (P = 0.0001) all correlated significantly with developmental outcome, whereas fetal heart rate monitoring, mode of delivery, and presence of the non-neurologic hypoxic-ischemic encephalopathy syndrome did not. In the multivariate analysis, a combination of the 48-hour EEG and 48-hour cranial ultrasound provided the best model to predict developmental outcome, and a point system to predict developmental outcome based on these two variables is proposed.
mesh_terms: D000704:Analysis of Variance; D001034:Apgar Score; D002658:Developmental Disabilities / Q000175:diagnosis / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D015997:Neonatal Screening / Q000379:methods*; D009460:Neurologic Examination / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology; D018709:Statistics, Nonparametric