Neurodevelopmental outcomes at 9–14 months gestational age after treatment of neonatal seizures due to brain injury
Infants with brain injury are susceptible to developmental delays. Survivors of neonatal seizures are at risk for developmental delay, epilepsy, and further neurological comorbidities. Despite advances in neonatal critical care, the prevalence of adverse long-term outcomes and seizure recurrence remains unchanged. Our goal is to determine if early treatment of neonatal seizures with phenobarbital or levetiracetam is associated with worse neurodevelopmental outcomes in brain-injured infants.
We conducted a retrospective cohort study of 119 infants admitted between 2013 and 2017 who were at risk for developmental delay and assessed in our clinic. We compared brain injury infants with neonatal seizures to brain injury infants without neonatal seizures using Bayley scores (BSID III) at 9–14 months gestational age. A comparison of Bayley scores between those exposed to phenobarbital and levetiracetam was conducted.
Twenty-two children with neonatal seizures scored lower than 53 children without seizures in all domains with significant values in composite scores for cognitive function (p = 0.003) and language (p = 0.031). We found no difference in scores at 9–14 months between infants exposed to phenobarbital versus levetiracetam.
Our results suggest that in infants with brain injury, the occurrence of neonatal seizures has an adverse effect on neurodevelopmental outcomes. The choice of antiseizure medication may not play a significant role in their outcomes.
KeywordsDevelopmental delay Levetiracetam Bayley Scale Phenobarbital
Research reported in this publication was partly supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under grants UL1TR001427 and UL1TR000064. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was also supported by a grant from the University of Florida, Department of Pediatrics through the Children’s Miracle Network.
Suman Ghosh: Dr. Ghosh conceptualized and designed the study, designed data collection instruments, supervised data collection, and drafted and revised the manuscript.
Andrea C Cabassa Miskimen: Ms. Miskimen helped design data collection instruments, collected data, and reviewed and revised manuscript.
Matthew A Robinson: Mr. Robinson carried out the initial data analyses, provided statistical analysis and graphics, and contributed and reviewed the manuscript.
Baiming Zou: Dr. Zou carried out the initial data analyses, provided statistical analysis and graphics, and contributed and reviewed the manuscript.
Janet Brady: Ms. Brady collected data, performed diagnostics for the study, reviewed data, and contributed to the draft of the manuscript.
Michael Weiss: Dr. Weiss provided interpretation of data and critical review of the manuscript.
Peter B. Kang: Dr. Kang conceptualized and designed the study, reviewed and revised the manuscript, and provided senior mentorship.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to disclose.
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