539 - Hippocampal Injury Associated with Increased Exposure to Antiepileptic Medications in Term Newborns with Hypoxic Ischemic Encephalopathy

Poster Number: 539
Publication Number: 539.139

Erica Davenport, Brody School of Medicine at East Carolina University, Greenville, NC, United States; Lynnee Vaught, Brody School of Medicine at East Carolina University, Greenville, NC, United States; Eric M. Martin, Brody School of Medicine at East Carolina University, Greenville, NC, United States; Dmitry Tumin, Brody School of Medicine at East Carolina University, Greenville, NC, United States; John A. Kohler, Brody School of Medicine at East Carolina University, Greenville, NC, United States

Background: Hypoxic-ischemic encephalopathy (HIE) is a major cause of perinatal cerebral injury and resultant neurodevelopmental deficits. Specific areas of the developing brain are particularly prone to hypoxic insult, importantly the hippocampus. Seizures are a common clinical manifestation in HIE and are associated with worse neurodevelopmental outcomes.

Objective: The current study sought to investigate the relationship between injury to the hippocampus on clinical presentation of HIE and developmental follow-up.

Design/Methods: A retrospective, cohort study examined data from the electronic health records from the James and Connie Maynard Children’s Hospital a major referral site for a rural 29-county area in eastern North Carolina. In-born and transferred-in infants born from January 2013 to June 2020 were included if they had a diagnosis of HIE and received a magnetic resonance image (MRI) during their hospitalization. Pertinent demographic and medical data and MRI images were extracted from the electronic health record. MRI images were independently reviewed by a single neuroradiologist.

Results: We screened 34 patients and excluded 12 patients due to the infant’s demise and 2 patients due to lack of MRI studies during the hospitalization. Twenty infants met criteria for inclusion, of whom 9 (45%) had hippocampal injury noted on MRI. 5 of 9 patients with hippocampal injury had seizures, compared to 3 of 11 patients without hippocampal injury (OR=1.56; Fisher’s exact p=0.362). 5 of 9 patients with hippocampal injury received phenobarbital, compared to 3 of 11 patients without hippocampal injury (OR=1.56; Fisher’s exact p=0.362).Conclusion(s): Infants with a diagnosis of hypoxic ischemic encephalopathy with hippocampal injury may be at increased risk for presentation with seizure-like activity and resulting treatment with antiepileptic medications.
ResultsPatients with or without hippocampal injury who had seizures and received Phenobarbital