Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy

Francesco Pisani, Carlotta Facini, Elisa Bianchi, Giorgia Giussani, Benedetta Piccolo, Ettore Beghi

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Information about the incidence of neonatal seizures (NS) is scarce. Previous studies relied primarily on a clinical diagnosis of seizures. This population-based, retrospective study evaluated the incidence of electroencephalography (EEG)-confirmed seizures in neonates born in the province of Parma and the perinatal risk factors for mortality and epilepsy.

METHODS: All neonates with suspected seizures or with medical conditions at high risk for seizures from the study area were recorded in the neonatal intensive care unit (NICU) of the Parma University Hospital. NS were EEG confirmed. Perinatal risk factors for mortality and epilepsy after NS were evaluated with Cox's proportional hazards models.

RESULTS: In a 13-year period, 112 patients presented with NS: 102 newborns had electroclinical seizures (46 full-term and 56 preterm), whereas 10 presented only electrical seizures. The incidence was 2.29/1000 live births (95% confidence interval [CI] 1.87-2.72), with higher rates in preterm neonates (14.28/1000 in preterm vs 1.10/1000 in full-term infants). The incidence increased with decreasing gestational age (31-36 weeks of gestation: 5.01/1000, 28-30: 54.9/1000, and <28: 85.6/1000) and with decreasing birth weight (≥2500 g: 1.19/1000, <1000 g: 127.57/1000). Twenty-eight patients (25%) died, 16 (14.3%) had a diagnosis of epilepsy, 33 (29.5%) had cerebral palsy, and 39 (34.8%) had a developmental delay. Among the perinatal risk factors considered, the multivariate analysis showed an association between a 5-minute Apgar score of 0-7 and etiology with increased mortality and between female gender and status epilepticus with epilepsy.

SIGNIFICANCE: The incidence of NS is inversely associated with gestational age and birth weight. The etiology and a low Apgar score are strongly related to mortality; female gender and status epilepticus are risk factors for the development of epilepsy.

Original languageEnglish
Pages (from-to)1764-1773
Number of pages10
JournalEpilepsia
Volume59
Issue number9
DOIs
Publication statusPublished - Sep 2018

Fingerprint

Infant Mortality
Italy
Epilepsy
Seizures
Incidence
Newborn Infant
Apgar Score
Mortality
Status Epilepticus
Birth Weight
Gestational Age
Electroencephalography
Neonatal Intensive Care Units
Live Birth
Cerebral Palsy
Proportional Hazards Models
Multivariate Analysis
Retrospective Studies
Confidence Intervals
Pregnancy

Cite this

Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy. / Pisani, Francesco; Facini, Carlotta; Bianchi, Elisa; Giussani, Giorgia; Piccolo, Benedetta; Beghi, Ettore.

In: Epilepsia, Vol. 59, No. 9, 09.2018, p. 1764-1773.

Research output: Contribution to journalArticle

Pisani, Francesco ; Facini, Carlotta ; Bianchi, Elisa ; Giussani, Giorgia ; Piccolo, Benedetta ; Beghi, Ettore. / Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy. In: Epilepsia. 2018 ; Vol. 59, No. 9. pp. 1764-1773.
@article{766939fba59f4a22b439758a176289a9,
title = "Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy",
abstract = "OBJECTIVE: Information about the incidence of neonatal seizures (NS) is scarce. Previous studies relied primarily on a clinical diagnosis of seizures. This population-based, retrospective study evaluated the incidence of electroencephalography (EEG)-confirmed seizures in neonates born in the province of Parma and the perinatal risk factors for mortality and epilepsy.METHODS: All neonates with suspected seizures or with medical conditions at high risk for seizures from the study area were recorded in the neonatal intensive care unit (NICU) of the Parma University Hospital. NS were EEG confirmed. Perinatal risk factors for mortality and epilepsy after NS were evaluated with Cox's proportional hazards models.RESULTS: In a 13-year period, 112 patients presented with NS: 102 newborns had electroclinical seizures (46 full-term and 56 preterm), whereas 10 presented only electrical seizures. The incidence was 2.29/1000 live births (95{\%} confidence interval [CI] 1.87-2.72), with higher rates in preterm neonates (14.28/1000 in preterm vs 1.10/1000 in full-term infants). The incidence increased with decreasing gestational age (31-36 weeks of gestation: 5.01/1000, 28-30: 54.9/1000, and <28: 85.6/1000) and with decreasing birth weight (≥2500 g: 1.19/1000, <1000 g: 127.57/1000). Twenty-eight patients (25{\%}) died, 16 (14.3{\%}) had a diagnosis of epilepsy, 33 (29.5{\%}) had cerebral palsy, and 39 (34.8{\%}) had a developmental delay. Among the perinatal risk factors considered, the multivariate analysis showed an association between a 5-minute Apgar score of 0-7 and etiology with increased mortality and between female gender and status epilepticus with epilepsy.SIGNIFICANCE: The incidence of NS is inversely associated with gestational age and birth weight. The etiology and a low Apgar score are strongly related to mortality; female gender and status epilepticus are risk factors for the development of epilepsy.",
author = "Francesco Pisani and Carlotta Facini and Elisa Bianchi and Giorgia Giussani and Benedetta Piccolo and Ettore Beghi",
note = "Wiley Periodicals, Inc. {\circledC} 2018 International League Against Epilepsy.",
year = "2018",
month = "9",
doi = "10.1111/epi.14537",
language = "English",
volume = "59",
pages = "1764--1773",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Blackwell Publishing Inc.",
number = "9",

}

TY - JOUR

T1 - Incidence of neonatal seizures, perinatal risk factors for epilepsy and mortality after neonatal seizures in the province of Parma, Italy

AU - Pisani, Francesco

AU - Facini, Carlotta

AU - Bianchi, Elisa

AU - Giussani, Giorgia

AU - Piccolo, Benedetta

AU - Beghi, Ettore

N1 - Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

PY - 2018/9

Y1 - 2018/9

N2 - OBJECTIVE: Information about the incidence of neonatal seizures (NS) is scarce. Previous studies relied primarily on a clinical diagnosis of seizures. This population-based, retrospective study evaluated the incidence of electroencephalography (EEG)-confirmed seizures in neonates born in the province of Parma and the perinatal risk factors for mortality and epilepsy.METHODS: All neonates with suspected seizures or with medical conditions at high risk for seizures from the study area were recorded in the neonatal intensive care unit (NICU) of the Parma University Hospital. NS were EEG confirmed. Perinatal risk factors for mortality and epilepsy after NS were evaluated with Cox's proportional hazards models.RESULTS: In a 13-year period, 112 patients presented with NS: 102 newborns had electroclinical seizures (46 full-term and 56 preterm), whereas 10 presented only electrical seizures. The incidence was 2.29/1000 live births (95% confidence interval [CI] 1.87-2.72), with higher rates in preterm neonates (14.28/1000 in preterm vs 1.10/1000 in full-term infants). The incidence increased with decreasing gestational age (31-36 weeks of gestation: 5.01/1000, 28-30: 54.9/1000, and <28: 85.6/1000) and with decreasing birth weight (≥2500 g: 1.19/1000, <1000 g: 127.57/1000). Twenty-eight patients (25%) died, 16 (14.3%) had a diagnosis of epilepsy, 33 (29.5%) had cerebral palsy, and 39 (34.8%) had a developmental delay. Among the perinatal risk factors considered, the multivariate analysis showed an association between a 5-minute Apgar score of 0-7 and etiology with increased mortality and between female gender and status epilepticus with epilepsy.SIGNIFICANCE: The incidence of NS is inversely associated with gestational age and birth weight. The etiology and a low Apgar score are strongly related to mortality; female gender and status epilepticus are risk factors for the development of epilepsy.

AB - OBJECTIVE: Information about the incidence of neonatal seizures (NS) is scarce. Previous studies relied primarily on a clinical diagnosis of seizures. This population-based, retrospective study evaluated the incidence of electroencephalography (EEG)-confirmed seizures in neonates born in the province of Parma and the perinatal risk factors for mortality and epilepsy.METHODS: All neonates with suspected seizures or with medical conditions at high risk for seizures from the study area were recorded in the neonatal intensive care unit (NICU) of the Parma University Hospital. NS were EEG confirmed. Perinatal risk factors for mortality and epilepsy after NS were evaluated with Cox's proportional hazards models.RESULTS: In a 13-year period, 112 patients presented with NS: 102 newborns had electroclinical seizures (46 full-term and 56 preterm), whereas 10 presented only electrical seizures. The incidence was 2.29/1000 live births (95% confidence interval [CI] 1.87-2.72), with higher rates in preterm neonates (14.28/1000 in preterm vs 1.10/1000 in full-term infants). The incidence increased with decreasing gestational age (31-36 weeks of gestation: 5.01/1000, 28-30: 54.9/1000, and <28: 85.6/1000) and with decreasing birth weight (≥2500 g: 1.19/1000, <1000 g: 127.57/1000). Twenty-eight patients (25%) died, 16 (14.3%) had a diagnosis of epilepsy, 33 (29.5%) had cerebral palsy, and 39 (34.8%) had a developmental delay. Among the perinatal risk factors considered, the multivariate analysis showed an association between a 5-minute Apgar score of 0-7 and etiology with increased mortality and between female gender and status epilepticus with epilepsy.SIGNIFICANCE: The incidence of NS is inversely associated with gestational age and birth weight. The etiology and a low Apgar score are strongly related to mortality; female gender and status epilepticus are risk factors for the development of epilepsy.

U2 - 10.1111/epi.14537

DO - 10.1111/epi.14537

M3 - Article

C2 - 30132843

VL - 59

SP - 1764

EP - 1773

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 9

ER -