Epidemiology of neonatal stroke: A population-based study

Area of Science:

• Pediatric Neurology
• Neonatal Medicine
• Public Health Epidemiology

Background:

• Neonatal stroke (NS) is a significant concern affecting newborns.
• Understanding population-based data on NS is crucial for effective management and intervention.
• Previous international studies provide a benchmark for NS incidence and outcomes.

Purpose of the Study:

• To determine the population-based incidence of all neonatal stroke types in Nova Scotia.
• To describe the clinical presentation, management, and imaging features of neonatal stroke.
• To evaluate the long-term neurodevelopmental outcomes of affected children.

Main Methods:

• A population-based cohort of full-term neonates with NS was identified using the Nova Scotia Provincial Perinatal Follow-up Program Database (2007-2013).
• Review of perinatal data and neonatal clinical course.
• Standardized neurodevelopmental assessments at 18 and 36 months of age.

Main Results:

• The incidence of NS was 47 per 100,000 live births.
• Arterial ischemic stroke was the most common type (76%), followed by hemorrhagic stroke (17%) and cerebral sinovenous thrombosis (7%).
• Most neonates presented with seizures (86%) on day one of life; 79% had normal outcomes at 36 months, while 10% developed cerebral palsy and 10% had recurrent seizures.

Conclusions:

• Nova Scotia exhibits a higher NS incidence compared to international data.
• Despite higher incidence, neurodevelopmental outcomes at three years appear more favorable.
• Further research is warranted to elucidate the factors contributing to these observed differences in neonatal stroke incidence and outcomes.