Factors predictive of seizures and neurologic outcome in perinatal depression
| Autor: | Barbara Caravale, Mark H. Libenson, Federico Allemand |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2003 |
| Předmět: |
Male
Developmental Disabilities Encephalopathy Neurological disorder Hypoxic Ischemic Encephalopathy Statistics Nonparametric Epilepsy Neonatal Screening Developmental Neuroscience Predictive Value of Tests Seizures medicine Humans Prospective Studies Asphyxia Neurologic Examination Analysis of Variance Neonatal encephalopathy business.industry Infant Newborn Electroencephalography medicine.disease Neurology Anesthesia Pediatrics Perinatology and Child Health Hypoxia-Ischemia Brain Multivariate Analysis Apgar Score Base excess Female Neurology (clinical) medicine.symptom business Perinatal Depression |
| Popis: | To identify which early clinical variables are predictive of outcome in newborns with perinatal depression, we prospectively examined newborns with persistently abnormal neurologic examinations at 48 hours and (1) arterial pH ≤ 7.15, (2) 5-minute Apgar ≤ 5, (3) requirement for positive pressure ventilation in the delivery room, or (4) fetal heart rate monitoring abnormalities. Eighty-four such infants completed neurodevelopmental assessment at 1 year. Five-minute Apgar ( P = 0.0064), arterial pH ( P = 0.0065) and base excess ( P = 0.0003), neonatal encephalopathy grade at 48 hours and 7 days (both P = 0.0001), EEG at 48 hours and 7 days (both P = 0.0001), cranial ultrasound (US) at 48 hours ( P = 0.0013) and 7 days ( P = 0.0002), and the occurrence of neonatal seizures ( P = 0.0001) all correlated significantly with developmental outcome, whereas fetal heart rate monitoring, mode of delivery, and presence of the non-neurologic hypoxic-ischemic encephalopathy syndrome did not. In the multivariate analysis, a combination of the 48-hour EEG and 48-hour cranial ultrasound provided the best model to predict developmental outcome, and a point system to predict developmental outcome based on these two variables is proposed. |
| Databáze: | OpenAIRE |
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