The risk of epilepsy after neonatal seizures.

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Developmental Medicine and Child Neurology Pub Date : 2025-02-19 DOI:10.1111/dmcn.16255

Jeanette Tinggaard, Signe V Pedersen, Mads L Larsen, Andreas K Jensen, Gorm Greisen, Bo M Hansen, Christina E Hoei-Hansen

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Abstract

Aim: To estimate the cumulative risk of epilepsy after neonatal seizures and identify subpopulations at increased risk.

Method: This was a nationwide register-based cohort study including all children born in Denmark between 1997 and 2018. The cumulative risk of epilepsy in children with and without neonatal seizures was compared. Furthermore, neonatal seizures were stratified according to aetiology.

Results: We followed 1 294 377 children and identified 1998 neonatal survivors with neonatal seizures. The cumulative risk of epilepsy was 20.4% (95% confidence interval [CI] = 18.5-22.3) among children with neonatal seizures, compared to 1.15% (95% CI = 1.12-1.18) among children without. Epilepsy was diagnosed before 1 year of age in 11.4% of children with neonatal seizures, in an additional 4.5% between 1 year and 5 years, 3.1% between 5 years and 10 years, and 1.4% between 10 years and 22 years. The aetiologies of neonatal cerebral infarction, haemorrhage, or malformations (adjusted hazard ratio = 2.49, 95% CI = 1.98-3.14) and low Apgar score (1.49, 95% CI = 1.12-1.98) were associated with the highest risk of epilepsy, compared to children with seizures of unknown aetiology.

Interpretation: Epilepsy after neonatal seizures is common and remains a substantial risk throughout childhood. Aetiological risk factors are identifiable and relevant when planning appropriate information for parents and follow-up.

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新生儿癫痫发作后的癫痫风险。

目的：估计新生儿癫痫发作后癫痫的累积风险，并确定风险增加的亚人群。方法：这是一项全国性的基于登记的队列研究，包括1997年至2018年在丹麦出生的所有儿童。比较了有和没有新生儿癫痫发作的儿童癫痫的累积风险。此外，根据病因对新生儿癫痫发作进行分层。结果：我们随访了1 294 377名儿童，并确定了1998例新生儿癫痫幸存者。在有新生儿癫痫发作的儿童中，癫痫的累积风险为20.4%(95%可信区间[CI] = 18.5-22.3)，而在没有癫痫发作的儿童中，癫痫的累积风险为1.15% （95% CI = 1.12-1.18）。11.4%的新生儿癫痫发作儿童在1岁前被诊断为癫痫，另外还有4.5%在1岁至5岁之间，3.1%在5岁至10岁之间，1.4%在10岁至22岁之间。与病因不明的癫痫发作儿童相比，新生儿脑梗死、出血或畸形（校正风险比= 2.49,95% CI = 1.98-3.14）和低Apgar评分（1.49,95% CI = 1.12-1.98）的病因与癫痫的最高风险相关。解释：新生儿癫痫发作后的癫痫是常见的，并且在整个儿童时期仍然存在重大风险。当为父母和随访计划适当的信息时，病因危险因素是可识别的和相关的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.