Multifactorial Modeling of Post-Neonatal Epilepsy (PNE) Following Hypoxic-Ischemic Encephalopathy (HIE) in Neonates Presenting to a Neonatal Neurocritical Care Unit
Abstract number :
2.36
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1825907
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Tayyba Anwar, MD - Children's National Hospital; Taeun Chang, MD - Professor, Pediatrics and Neurology, Children's National Hospital; Oscar DeLaGarza-Pineda, MD - Attending Physician, Neurology, University Hospital “Dr. Jose E. Gonzalez” of the U.A.N.L; Ruoying Li - Research Assistant, Neurology, Children's National Hospital; An Massaro, MD - Associate Professor, Pediatrics and Neonatology, Children's National Hospital; Tira Oskoui - Research Assistant, Children's National Hospital; Tammy Tsuchida, MD, PhD - Professor, Pediatrics and Neurology, Children's National Hospital; Gilbert Vezina, MD - Professor, Pediatrics and Radiology, Children's National Hospital
Rationale: HIE in newborns is the most common acute symptomatic neurologic insult in the NICU, and many go on to develop PNE, including refractory epilepsy1. Little is known of the PNE risk factors associated with HIE other than the presence of neonatal seizures2-3. We aimed to develop a stratified risk model of early clinical, MRI and EEG predictors associated with PNE after moderate or severe HIE.
Methods: A retrospective cross-sectional study of PNE by 2 years of age in moderate-severe HIE newborns presenting 2006-2016 to Children’s National Hospital NICU for therapeutic hypothermia was performed. Inclusion criteria were availability of continuous EEG reports during cooling, a brain MRI completed in the acute neonatal period, and follow-up through 2 years of age. Exclusion criteria were a genetic, metabolic and/or congenital condition associated with epilepsy. Clinical history, Sarnat score, MRI location of injury & Barkovich score, and EEG background & seizure burden were collected. Bivariate analysis of the variables used Cox proportional hazards regression models with 95% confidence intervals. A Cox regression model was used for multivariable analysis. A p value< 0.05 was considered statistically significant.
Epidemiology