Abstract
Objective The aim of this study was to evaluate the association between neonatal seizure and
neurodevelopmental impairment (NDI) at 18 to 24 months in extremely preterm neonates.
The association between anticonvulsants use and NDI was also assessed.
Study Design In this retrospective cohort study of infants born at <29 weeks' gestation from the
Canadian Neonatal Network and Canadian Neonatal Follow-Up Network databases, we compared
mortality and neurodevelopmental outcomes in infants who had neonatal seizures with
those without seizures after adjusting for confounders.
Results Of the 2,762 eligible neonates, 133 (4.8%) had seizures. Infants who had seizures
were of lower gestation (25.2 vs. 26.2 weeks) and birth weight (819 vs. 920 g) and
had higher rates of adverse outcomes. Neonatal seizure was associated with higher
odds of composite outcome of death or significant NDI (74 vs. 27%; adjusted odds ratio
[OR]: 3.4; 95% confidence interval [CI]: 2.2–5.4). Death or significant NDI was higher
in infants with seizures treated with anticonvulsants than those without treatment
(89 vs. 70%); however, when adjusted for confounders, it was not significantly different
(adjusted OR: 3.5; 95% CI: 0.83–14.6).
Conclusion Neonatal seizures were independently associated with higher odds of death or significant
NDI at 18 to 24 months of age. Relationship of anticonvulsant and neurodevelopmental
outcomes needs further studies.
Keywords
preterm - seizure - neonatal - neurodevelopmental outcomes - neurodevelopmental impairment
anticonvulsant
