title: Seizures as a predictor of long-term neurodevelopmental outcome in survivors of neonatal extracorporeal membrane oxygenation (ECMO).
abstract: A longitudinal, prospective study was conducted to determine the long-term neurodevelopmental outcome in neonatal extracorporeal membrane oxygenation (ECMO) survivors with and without seizures. One hundred sixty-two ECMO survivors from March 1985 until November 1995 were eligible for follow-up. Sixty-four returned at preschool age (4-6 years). Thirty-nine infants did not experience neonatal seizures (group 1); however, 25 exhibited seizures before or during ECMO (group 2). Twelve infants referred for ECMO, but managed medically, served as a clinical comparison group (group 3). At school age (7-9 years), 32 ECMO children (16 with seizures) returned for neuropsychologic evaluation. The results indicated that the preschool seizure group (group 2) demonstrated a significantly lower mean IQ than group 1 or 3 (P = .002). Furthermore, 56% of group 2 had IQ scores < or =84 (> or =1 SD below the mean). Group 2 also exhibited significantly higher rates of cerebral palsy (P < or = .001) and speech-language disorder than group 1 or 3 (P < .001). At school age, the seizure group continued to perform below average on intelligence testing, with 50% scoring < or =84 and 38% receiving special education. This study extends the previous findings that seizures associated with neonatal ECMO are a primary risk factor for neurodevelopmental sequelae and confirms the need for long-term follow-up to assist with academic programming.
authors.affiliation: Department of Pediatrics Medical College of Georgia, Augusta, GA 30912-3255, USA.
authors.forename: Anjali P
authors.initials: AP
authors.lastname: Parish
authors.forename: Chantrapa
authors.initials: C
authors.lastname: Bunyapen
authors.forename: Morris J
authors.initials: MJ
authors.lastname: Cohen
authors.forename: Tara
authors.initials: T
authors.lastname: Garrison
authors.forename: Jatinder
authors.initials: J
authors.lastname: Bhatia
mesh_terms: D002657:Child Development / Q000502:physiology*; D002658:Developmental Disabilities / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007361:Intelligence Tests; D008297:Male; D008606:Mental Processes / Q000502:physiology*; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012640:Seizures / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome