Epilepsy After Electroencephalographically Verified Neonatal Seizures: A Swedish Population-Based Matched Cohort Study

IF 2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI:10.1016/j.pediatrneurol.2025.10.003

Hanna Westergren MD , Helena Marell Hesla MD, PhD , Maria Altman MD, PhD , Sara Freyland MSc , Ronny Wickström MD, PhD

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引用次数: 0

Abstract

Background

To study the risk of postneonatal epilepsy (PNE) after neonatal seizures with electroencephalographic verification, regardless of cause. To investigate which antiseizure medications (ASMs) were used during neonatal hospitalization and to what extent infants were discharged with ASMs from neonatal care.

Methods

A Swedish nationwide population-based cohort study, based on national health care registries, including children born from 2009 to 2020. Exposure: Neonatal seizures, verified with electroencephalogram and/or amplitude-integrated electroencephalogram. Outcome: PNE, with cumulative incidence at 2 and 7 years of age and hazard ratios, excluding children with neonatal onset epilepsy. Follow-up period: January 1, 2009, to December 31, 2021.

Results

The cumulative incidence of PNE was 15.7% (95% confidence interval [CI]: 13.5-18.9) at 2 years and 22.4% (95% CI: 19.8-25.2) at 7 years of age in children with neonatal seizures. For controls, the corresponding incidences were 0.11% (95% CI: 0.05-0.24) and 0.56% (95% CI: 0.36-0.84). The adjusted hazard ratio for PNE following neonatal seizures was 50.3 (95% CI: 33.5-75.5). Phenobarbital was the most commonly used ASM during neonatal hospitalization. The proportions of infants discharged with ASM decreased during the study period from over 70% to 8%, while the risk of PNE remained unchanged.

Conclusions

Children with electroencephalographically verified seizures in the neonatal period are at high risk of developing PNE, vastly surpassing that of the unaffected population. The findings indicate the importance of a standardized clinical follow-up of the affected children and that further research is needed to investigate the impact of seizures per se in specific subgroups.

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脑电图证实的新生儿癫痫发作后癫痫：一项基于瑞典人群的匹配队列研究。

背景：通过脑电图验证研究新生儿癫痫发作后发生新生儿癫痫（PNE）的风险，不论病因。目的：探讨新生儿住院期间抗癫痫药物（asm）的使用情况，以及新生儿因抗癫痫药物出院的程度。方法：瑞典全国人口队列研究，基于国家卫生保健登记，包括2009年至2020年出生的儿童。暴露：新生儿癫痫发作，经脑电图和/或振幅综合脑电图证实。结果：PNE， 2岁和7岁的累积发病率和风险比，不包括新生儿癫痫发作的儿童。跟进期：2009年1月1日至2021年12月31日。结果：新生儿癫痫患儿2岁时PNE的累积发病率为15.7%(95%可信区间[CI]: 13.5-18.9)， 7岁时PNE的累积发病率为22.4% （95% CI: 19.8-25.2）。对于对照组，相应的发病率为0.11% （95% CI: 0.05-0.24）和0.56% （95% CI: 0.36-0.84）。新生儿癫痫发作后PNE的校正风险比为50.3 （95% CI: 33.5-75.5）。苯巴比妥是新生儿住院期间最常用的ASM。在研究期间，因ASM出院的婴儿比例从70%以上下降到8%，而PNE的风险保持不变。结论：在新生儿期脑电图证实癫痫发作的儿童患PNE的风险很高，远远超过未受影响的人群。研究结果表明，对受影响儿童进行标准化临床随访的重要性，需要进一步研究癫痫发作本身对特定亚组的影响。

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

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.