Effect of neonatal seizure burden and etiology on the long-term outcome: data from a randomized, controlled trial.
Effect of neonatal seizure burden and etiology on the long-term outcome: data from a randomized, controlled trial.
复制标题
新生儿癫痫发作负担和病因对长期结果的影响：来自随机对照试验的数据。
DOI：
10.1002/cns3.8
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
BostonBumetanideTrialGroup
中科院分区：
文献类型：
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作者：
Trowbridge,SaraK;Condie,LoisO;Landers,JessicaR;Bergin,AnnM;Grant,PatriciaE;Krishnamoorthy,Kalpathy;Rofeberg,Valerie;Wypij,David;Staley,KevinJ;Soul,JanetS;BostonBumetanideTrialGroup
背景新生儿癫痫发作很常见，但新生儿癫痫发作对长期神经学结局的影响仍不清楚。我们通过分析布美他尼治疗新生儿癫痫发作的早期对照试验的数据来解决这个问题。神经系统的结果是由标准化的发育测试和新生儿后癫痫recursion.ResultsOf 111登记的新生儿，43被随机分配到治疗组或对照组。治疗组和对照组之间的神经功能结局无差异。对84例围产期急性脑损伤新生儿进行亚组分析，其中缺氧缺血性脑病（HIE）57例，脑卒中18例，颅内出血（ICH）9例，其中大多数（70%）有新生儿癫痫发作。癫痫负荷与发育评分呈显著负相关（p< 0.01）。与ICH组相比，HIE和卒中组中癫痫负荷和发育评分之间的相关性更强（p< 0.05）。结论布美他尼未显示长期有益或不良影响，正如基于治疗持续时间与新生儿癫痫持续时间的预期。对于围产期脑损伤的新生儿，较高的新生儿癫痫发作负担与较差的发育结局显著相关，尤其是缺血性脑损伤与出血性脑损伤。这些数据强调需要进一步研究新生儿癫痫发作严重程度和病因的长期影响。
BackgroundNeonatal seizures are common, but the impact of neonatal seizures on long‐term neurologic outcomes remains unclear. We addressed this question by analyzing data from an early‐phase controlled trial of bumetanide to treat neonatal seizures.MethodsNeonatal seizure burden was calculated from continuous video‐electroencephalogram data. Neurologic outcome was determined by standardized developmental tests and postneonatal seizure recurrence.ResultsOf 111 enrolled neonates, 43 were randomized to treatment or control groups. There were no differences in neurologic outcomes between treatment and control groups. A subgroup analysis was performed for 84 neonates with acute perinatal brain injury (57 hypoxic–ischemic encephalopathy [HIE], 18 stroke, 9 intracranial hemorrhage [ICH]), most of whom (70%) had neonatal seizures. There was a significant negative correlation between seizure burden and developmental scores (p< 0.01). Associations between seizure burden and developmental scores were stronger in HIE and stroke groups compared with ICH (p< 0.05).ConclusionBumetanide showed no long‐term beneficial or adverse effects, as expected based on treatment duration versus duration of neonatal seizures. For neonates with perinatal brain injury, higher neonatal seizure burden correlated significantly with the worse developmental outcome, particularly for ischemic versus hemorrhagic brain injury. These data highlight the need for further investigation of the long‐term effects of both neonatal seizure severity and etiology.