Early Electrographic Seizures, Brain Injury an Neurodevelopmental Risk in the Very Preterm Infant

BACKGROUND: Previous studies of very preterm (VPT) infants have shown a wide range of seizure prevalence and association with intraventricular hemorrhage (IVH), white matter injury (WMI) and death. However, the impact of seizures on neurodevelopment is not well known. We hypothesized that seizures in the first three days after VPT birth would be associated with increased radiographic brain injury and later neurodevelopmental risk. METHODS: For 72 hours after birth 95 VPT infants underwent aEEG monitoring. High and low seizure burdens were related to radiographic brain injury, death in the neonatal period and children’s Bayley III performance at 2 years corrected age in a subgroup of 59 infants. RESULTS: The overall incidence of seizures in this sample was 48%. High seizure burden was associated with increased risk of IVH on day 1; IVH, WMI and death on day 2 and high grade IVH on day 3. The presence of seizures on any day was associated with decreased language performance at age 2, even after controlling for family social risk. CONCLUSIONS: Seizures during the first three days after birth are common and are associated with an increased risk of IVH, WMI and death. They were also associated with poorer early language development.