Neonatal Seizures in Preterm Infants: Characteristics and Long-Term Outcome

Background: Preterm infants with a birth weight > 1,500 g (VLBW) are at high risk for intellectual disability or cerebral palsy. This risk is lower for preterm infants with a birth weight between 1,500 and 2,500 g (LBW). Seizures occur more often in VLBW, mostly associated with brain lesions such as cerebral hemorrhage or periventricular leukomalacia. We aimed to investigate etiology, clinical course and long-term outcome of VLBW and LBW preterm infants with neonatal seizures.

Methods: Our retrospective monocenter study included 54 preterm infants with neonatal seizures (40 VLBW and 14 LBW) born between 2008 and 2011. Cognitive testing with the K-ABC test was performed at the age of 6.2 ± 2.0 years (mean + SD).

Results: In the VLBW group, seizures occurred later than in the LBW group (13±11 vs. 9±8 d). All infants received phenobarbital as a first-line therapy. The most common cause of neonatal seizures in the VLBW group was higher-grade intracranial hemorrhages (18%). Etiology in the LBW group was more heterogenous and included cerebral malformations (n = 3, 23%) and genetic causes. At the mean age of 6.2 ± 2.0 years, 44.4% of VLBW and 71.4% of LBW preterm infants showed intellectual disability, 22.0% of VLBW and 42.9% of LBW showed cerebral palsy.

Conclusion: Both VLBW and LBW preterm infants with neonatal seizures are at high risk for intellectual disability and cerebral palsy. The high number of LBW preterm infants in our study resulted from the different etiology: brain malformations and genetic causes were more common in this group of patients.

Publication History

Article published online:
28 October 2021