Neurodevelopmental outcomes at 9–14 months gestational age after treatment of neonatal seizures due to brain injury

Suman Ghosh; Andrea C. Cabassa Miskimen; Janet Brady; Matthew A. Robinson; Baiming Zou; Michael Weiss; Peter B. Kang

doi:10.1007/s00381-019-04286-x

Neurodevelopmental outcomes at 9–14 months gestational age after treatment of neonatal seizures due to brain injury

Suman Ghosh, Andrea C. Cabassa Miskimen, Janet Brady, Matthew A. Robinson, Baiming Zou, Michael Weiss, Peter B. Kang

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: Infants with brain injury are susceptible to developmental delays. Survivors of neonatal seizures are at risk for developmental delay, epilepsy, and further neurological comorbidities. Despite advances in neonatal critical care, the prevalence of adverse long-term outcomes and seizure recurrence remains unchanged. Our goal is to determine if early treatment of neonatal seizures with phenobarbital or levetiracetam is associated with worse neurodevelopmental outcomes in brain-injured infants. Methods: We conducted a retrospective cohort study of 119 infants admitted between 2013 and 2017 who were at risk for developmental delay and assessed in our clinic. We compared brain injury infants with neonatal seizures to brain injury infants without neonatal seizures using Bayley scores (BSID III) at 9–14 months gestational age. A comparison of Bayley scores between those exposed to phenobarbital and levetiracetam was conducted. Results: Twenty-two children with neonatal seizures scored lower than 53 children without seizures in all domains with significant values in composite scores for cognitive function (p = 0.003) and language (p = 0.031). We found no difference in scores at 9–14 months between infants exposed to phenobarbital versus levetiracetam. Conclusions: Our results suggest that in infants with brain injury, the occurrence of neonatal seizures has an adverse effect on neurodevelopmental outcomes. The choice of antiseizure medication may not play a significant role in their outcomes.

Original language	English (US)
Pages (from-to)	1571-1578
Number of pages	8
Journal	Child's Nervous System
Volume	35
Issue number	9
DOIs	https://doi.org/10.1007/s00381-019-04286-x
State	Published - Sep 1 2019
Externally published	Yes

Bibliographical note

Funding Information:
Research reported in this publication was partly supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under grants UL1TR001427 and UL1TR000064. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by a grant from the University of Florida, Department of Pediatrics through the Children’s Miracle Network.

Funding Information:
Research reported in this publication was partly supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under grants UL1TR001427 and UL1TR000064. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by a grant from the University of Florida, Department of Pediatrics through the Children?s Miracle Network.

Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

Keywords

Bayley Scale
Developmental delay
Levetiracetam
Phenobarbital

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10.1007/s00381-019-04286-x

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Cite this

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title = "Neurodevelopmental outcomes at 9–14 months gestational age after treatment of neonatal seizures due to brain injury",

abstract = "Purpose: Infants with brain injury are susceptible to developmental delays. Survivors of neonatal seizures are at risk for developmental delay, epilepsy, and further neurological comorbidities. Despite advances in neonatal critical care, the prevalence of adverse long-term outcomes and seizure recurrence remains unchanged. Our goal is to determine if early treatment of neonatal seizures with phenobarbital or levetiracetam is associated with worse neurodevelopmental outcomes in brain-injured infants. Methods: We conducted a retrospective cohort study of 119 infants admitted between 2013 and 2017 who were at risk for developmental delay and assessed in our clinic. We compared brain injury infants with neonatal seizures to brain injury infants without neonatal seizures using Bayley scores (BSID III) at 9–14 months gestational age. A comparison of Bayley scores between those exposed to phenobarbital and levetiracetam was conducted. Results: Twenty-two children with neonatal seizures scored lower than 53 children without seizures in all domains with significant values in composite scores for cognitive function (p = 0.003) and language (p = 0.031). We found no difference in scores at 9–14 months between infants exposed to phenobarbital versus levetiracetam. Conclusions: Our results suggest that in infants with brain injury, the occurrence of neonatal seizures has an adverse effect on neurodevelopmental outcomes. The choice of antiseizure medication may not play a significant role in their outcomes.",

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author = "Suman Ghosh and {Cabassa Miskimen}, {Andrea C.} and Janet Brady and Robinson, {Matthew A.} and Baiming Zou and Michael Weiss and Kang, {Peter B.}",

note = "Funding Information: Research reported in this publication was partly supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under grants UL1TR001427 and UL1TR000064. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by a grant from the University of Florida, Department of Pediatrics through the Children{\textquoteright}s Miracle Network. Funding Information: Research reported in this publication was partly supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under grants UL1TR001427 and UL1TR000064. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by a grant from the University of Florida, Department of Pediatrics through the Children?s Miracle Network. Publisher Copyright: {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",

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AU - Cabassa Miskimen, Andrea C.

AU - Brady, Janet

AU - Robinson, Matthew A.

AU - Zou, Baiming

AU - Weiss, Michael

AU - Kang, Peter B.

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N2 - Purpose: Infants with brain injury are susceptible to developmental delays. Survivors of neonatal seizures are at risk for developmental delay, epilepsy, and further neurological comorbidities. Despite advances in neonatal critical care, the prevalence of adverse long-term outcomes and seizure recurrence remains unchanged. Our goal is to determine if early treatment of neonatal seizures with phenobarbital or levetiracetam is associated with worse neurodevelopmental outcomes in brain-injured infants. Methods: We conducted a retrospective cohort study of 119 infants admitted between 2013 and 2017 who were at risk for developmental delay and assessed in our clinic. We compared brain injury infants with neonatal seizures to brain injury infants without neonatal seizures using Bayley scores (BSID III) at 9–14 months gestational age. A comparison of Bayley scores between those exposed to phenobarbital and levetiracetam was conducted. Results: Twenty-two children with neonatal seizures scored lower than 53 children without seizures in all domains with significant values in composite scores for cognitive function (p = 0.003) and language (p = 0.031). We found no difference in scores at 9–14 months between infants exposed to phenobarbital versus levetiracetam. Conclusions: Our results suggest that in infants with brain injury, the occurrence of neonatal seizures has an adverse effect on neurodevelopmental outcomes. The choice of antiseizure medication may not play a significant role in their outcomes.

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