Abstracts

Rationale: Extremely premature infants (EPI) (less than 28 weeks) have been shown to be prone to neonatal seizures, and response to phenobarbital has been documented. The purpose of this study is to evaluate clinical seizures in extreme low birth weight (less than 500 gm) in comparison to bigger neonates (weight less than 1000 gm and at least 500 gm).

Methods: A retrospective study was conducted with all EPI (less than 28 weeks) in our neonatal intensive care unit (NICU) between January 1, 2023, and June 10, 2024. Clinical seizures were suspected based on abnormal movements (tonic, clonic, myoclonic, or subtle tongue thrusting/cycling). Documentation of use of anticonvulsant therapy was necessary to establish that event was a seizure. The etiology of seizures was established after reviewing laboratory and echoencephalograms using a GE Vivid E 95.


Results:
There were 124 EPI. Twenty-two were less than 500 gm with a mean weight of 436 gm and mean gestational age of 23 weeks. One infant with a grade 4 intracranial hemorrhage (ICH) had seizures. In the other infant with a grade 4 ICH, no seizures were recognized. The other infants did well, except one who died shortly after birth. There were 102 bigger neonates. Ten of them were treated for seizures. Their average weight was 610 gm while their average gestational age was 23 weeks The etiology was Grade 4 in 9 and meningitis in 1. Seven other infants in this group developed sepsis and died. Other infants did well without ICH lager than grade 2


Conclusions: Seizures are not more frequent in extreme premature infants with extremely low birth weight.


Funding: none