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

• Published in: Epilepsia (Copenhagen) 2018-09, Vol.59 (9), p.1764-1773
• Main Authors: Pisani, Francesco, Facini, Carlotta, Bianchi, Elisa, Giussani, Giorgia, Piccolo, Benedetta, Beghi, Ettore
• Format: Article
• Language: English
• Subjects: Apgar score; Birth weight; Community Health Planning; Convulsions & seizures; Diagnosis; EEG; Electroencephalography; Epilepsy; Epilepsy - complications; Epilepsy - epidemiology; Epilepsy - mortality; Etiology; Female; Gestational age; Health risk assessment; Humans; Incidence; incidence of seizures; Infant; Infant, Newborn; Infant, Newborn, Diseases - epidemiology; Infant, Newborn, Diseases - mortality; Infant, Newborn, Diseases - physiopathology; Infant, Premature; Infants; Intensive Care, Neonatal - statistics & numerical data; Italy - epidemiology; Male; Mortality; Multivariate analysis; Neonatal care; neonatal neurology; neonatal seizures; Neonates; newborns; Paralysis; Population studies; Risk factors; risk factors for seizures; Seizures
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/epi.14537

Summary 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