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Factors associated with the development of epilepsy in very low birth weight infants

Toshimichi Fukao1, Fumikazu Sano2, Atsushi Nemoto1

  • 1Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan; Department of Neonatology, Perinatal Medical Center, Yamanashi Prefectural Central Hospital, Yamanashi, Japan.

Pediatrics and Neonatology
|April 28, 2023
PubMed

Insights

Epilepsy affects 4.0% of very low birth weight (VLBW) infants, with risk factors like brain anomalies and neonatal seizures. Early identification of these factors is crucial for monitoring and treatment protocols in VLBW infants.

Area of Science:

  • Neonatal neurology
  • Pediatric epilepsy
  • Perinatal medicine

Background:

  • Survival rates for very low birth weight (VLBW) infants have improved.
  • Epilepsy incidence and associated factors in VLBW infants are not well understood.
  • This study addresses the knowledge gap regarding epilepsy in VLBW infants.

Purpose of the Study:

  • To determine the incidence of epilepsy in VLBW infants.
  • To identify characteristics and risk factors associated with epilepsy development in VLBW infants.
  • To analyze the temporal features of epilepsy onset in VLBW infants.

Main Methods:

  • A retrospective study included VLBW infants admitted between 2012 and 2017 with a follow-up of at least 1 year.
  • Identified risk factors included chromosomal abnormalities, brain anomalies, severe intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (PVL), and hypoxic ischemic encephalopathy (HIE).
  • Data on neonatal seizures, maternal age, maternal diabetes, antenatal corticosteroid use, and Apgar scores were collected.

Main Results:

  • Epilepsy occurred in 4.0% (21/526) of VLBW infants.
  • Risk factors for epilepsy included chromosomal abnormalities, brain anomalies, severe IVH, cystic PVL, HIE, neonatal seizures, advanced maternal age, maternal diabetes, lack of antenatal corticosteroids, and low Apgar scores.
  • Epilepsy onset occurred earlier and at a higher rate in VLBW infants with risk factors, with 86.7% developing epilepsy within 2 years of age.

Conclusions:

  • Identified risk factors and temporal patterns of epilepsy in VLBW infants are crucial for developing monitoring and treatment strategies.
  • Early identification of VLBW infants at risk for epilepsy can facilitate timely intervention.
  • Further research into specific monitoring and treatment protocols is warranted.
Abstract

Keywords:
Cysticperiventricular leukomalaciaEpilepsyHypoxic ischemic encephalopathyIntraventricular hemorrhageVery low birth weight infants

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