Predictors of poor neurodevelopmental outcomes in neonates with clinically observed seizures: A prospective observational study in a tertiary care hospital of Bangladesh

• Published in: Epilepsy & behavior reports 2024, Vol.26, p.100665-100665, Article 100665
• Main Authors: Akter, Humayra, Dey, Sanjoy Kumer, Shabuj, Mohammad Kamrul Hassan, Fatema, Kanij, Jahan, Ismat, Sihan, Nazmus, Rahman, Tareq, Khan, Md Abdullah Saeed, Hasan, Mohammad Jahid
• Format: Article
• Language: English
• Subjects: Adverse neurodevelopmental outcome; EEG; Neonates; Perinatal asphyxia; Seizures
• ISSN: 2589-9864; 2589-9864
• DOI: 10.1016/j.ebr.2024.100665

•Approximately one-third of the neonates with clinically observed seizures die in the hospital.•More than half of those discharged develop neurodevelopmental disorder (NDD) within nine months.•Global developmental delay is the most common neurodevelopmental disorder.•More than one-fourth have concomitant cerebral palsy, epilepsy, and global developmental delay.•Recurrent seizures, antiepileptics needed, and abnormal EEG findings are key predictors of NDD. Neonatal seizures can lead to long-term neurodevelopmental problems. This study aims to identify predictors of poor developmental outcomes in neonates with seizures to aid in early intervention and referral for follow-up and rehabilitation. This observational study was conducted in the Department of Neonatology and Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University. Among 75 study cases of neonatal seizure, 23 died, and 46 were followed-up at 6 and 9 months after discharge. EEGs were performed on every patient. A comprehensive neurological examination and developmental evaluation were performed using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III). Three-fourths of neonates were born at term (76.1 %), and over half were male (56.5 %). The majority were appropriate for gestational age (79.7 %) and had an average birth weight of 2607 ± 696 g (±SD). Over half of the neonates (52.2 %) had adverse neurodevelopmental outcomes, with global developmental delay being the most common. Recurrent seizures, the number of anticonvulsants needed to control seizures, and abnormal Electroencephalograms were identified as independent predictors of adverse neurodevelopmental outcomes. The study highlights the need for early referral for follow-up and rehabilitation of neonates with seizures having abnormal electroencephalograms, recurrent seizures and requiring more anticonvulsants to control seizures.