Seizures in extremely low birth weight infants are associated with adverse outcome.
OBJECTIVE
To examine risk factors for neonatal clinical seizures and to determine the independent association with death or neurodevelopmental impairment (NDI) in extremely low birth weight (ELBW) infants.


METHODS
A total of 6499 ELBW infants (401-1000 g) surviving to 36 weeks postmenstrual age (PMA) were included in this retrospective study. Unadjusted comparisons were performed between infants with (n = 414) and without (n = 6085) clinical seizures during the initial hospitalization. Using multivariate logistic regression modeling, we examined the independent association of seizures with late death (after 36 weeks PMA) or NDI after controlling for multiple demographic, perinatal, and neonatal variables.


RESULTS
Infants with clinical seizures had a greater proportion of neonatal morbidities associated with poor outcome, including severe intraventricular hemorrhage, sepsis, meningitis, and cystic periventricular leukomalacia (all P < .01). Survivors were more likely to have NDI or moderate-severe cerebral palsy at 18 to 22 months corrected age (both P < .01). After adjusting for multiple confounders, clinical seizures remained significantly associated with late death or NDI (odds ratio, 3.15; 95% CI, 2.37-4.19).


CONCLUSIONS
ELBW infants with clinical seizures are at increased risk for adverse neurodevelopmental outcome, independent of multiple confounding factors.
Davis
Alexis S
AS
Division of Neonatal-Developmental Medicine, Stanford University, Stanford, CA, USA.
Hintz
Susan R
SR
Van Meurs
Krisa P
KP
Li
Lei
L
Das
Abhik
A
Stoll
Barbara J
BJ
Walsh
Michele C
MC
Pappas
Athina
A
Bell
Edward F
EF
Laptook
Abbot R
AR
Higgins
Rosemary D
RD
D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000150:complications* / Q000453:epidemiology*; D013997:Time Factors