545 - Neurodevelopmental Outcomes in Premature Neonates Diagnosed with Seizures Clinically vs. using Electroencephalogram

Poster Number: 545
Publication Number: 545.139

Savina Reid-Herrera, Cooper Medical School of Rowan University, Camden, NJ, United States; Nikhil Bhana, Cooper Medical School of Rowan University, Cinnaminson, NJ, United States; Avish Patel, Cooper Medical School of Rowan University, Philadelphia, PA, United States; Krystal Hunter, Cooper Medical School of Rowan University, Camden, NJ, United States; Alla Kushnir, The Children's Regional Hospital at Cooper, Camden, NJ, United States

Background: Neonatal seizures can be associated with long-term sequelae, especially among preterm neonates. While there has been a reduction in mortality over the last decade, morbidity is still a problem. Seizures in preterm neonates are often diagnosed clinically and treatment is started prior to electroencephalogram (EEG) verification. By evaluating neurodevelopmental outcomes in preterm infants who experience seizures diagnosed by various methods, it may guide clinicians in the timing of starting treatment for seizures.

Objective: Determine whether there is a difference in neurodevelopmental outcomes at 12-24 months corrected gestational age (CGA) among preterm neonates diagnosed with seizures clinically compared to using electroencephalogram (EEG).

Design/Methods: Premature neonates ( < 37 weeks) born at a tertiary urban hospital between 2009 and 2019 who were admitted to the neonatal intensive care unit (NICU) and were diagnosed with seizures clinically and/or via EEG were included in this retrospective chart review. Patients were excluded if they passed away prior to discharge, had no confirmed seizure activity at discharge from the NICU, were diagnosed with Neonatal Abstinence Syndrome, were transferred to another hospital for escalation of care, or had insufficient follow-up data. Developmental milestones (12, 18, and 24 months CGA) and the Bayley Scale of Infant Development III (BSID III) were recorded and compared.

Results: Of 335 patients, 56 premature neonates were included. Of these, 29 (51.8%) were male, mean birth weight of 1087.9 grams (SD=815.9). There were 38 (67.9%) under 28 weeks, 8 (14.3%) between 28 weeks and 31 weeks 6 days, and 10 (17.9%) between 32 weeks and 36 weeks 6 days. Additionally, 32 (57.1%) were African American, 12 (21.4%) Hispanic, 8 (14.3%) White, and 4 (7.1%) ‘Other Races’. Overall, any type of neurodevelopmental impairment was present in 27/56 (48.2%) at 12-months and 25/47 (53.2%) at 18-24 months. Seizure diagnosis was confirmed via EEG in 12 (21.4%) patients. There was no statistical difference in neurodevelopmental outcomes between preterm neonates diagnosed with seizures clinically and via EEG (48% vs. 50% at 12 months (p=0.89), and 55% vs. 43% at 18-24 months (p=0.55)).Conclusion(s): There was no difference in neurodevelopmental outcomes among preterm neonates diagnosed with seizures clinically vs. by EEG. Overall rate of disability was high in this sample, but it may indicate that regardless of the mode of diagnosis, early therapies and intervention may be necessary for these patients.
Neurodevelopmental Outcomes in Premature Neonates Diagnosed with Seizures Clinically vs. using ElectroencephalogramCurrent Job Resume SREID.pdf