title: Preterm infants with video-EEG confirmed seizures: outcome at 30 months of age.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Child Neuropsychiatric Unit, Neuroscience Department, University of Parma, Italy. francesco.pisani@unipr.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisani
authors.forename: Angela Luciana
authors.initials: AL
authors.lastname: Barilli
authors.forename: Lisa
authors.initials: L
authors.lastname: Sisti
authors.forename: Giulio
authors.initials: G
authors.lastname: Bevilacqua
authors.forename: Stefano
authors.initials: S
authors.lastname: Seri
mesh_terms: D017668:Age of Onset; D001034:Apgar Score; D001925:Brain Damage, Chronic / Q000401:mortality; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000401:mortality; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000503:physiopathology; D020936:Epilepsy, Benign Neonatal / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography; D014741:Video Recording / Q000379:methods*