Publication:

Evaluation of the predictors of epilepsy in hypoxic ischemic encephalopathy term neonates

Background Hypoxic ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality, particularly in term infants. Neonates with severe HIE are at high risk for long-term neurological consequences, including epilepsy. This study aims to identify clinical, biochemical, and neuroimaging predictors of epilepsy in HIE neonates.

Methods A prospective cohort study was conducted on 100 term neonates diagnosed with HIE at a tertiary neonatal intensive care unit (NICU) in India. Data including gestational age, birth weight, Apgar scores, clinical features, neuroimaging results (MRI/CT), serum lactate levels, and EEG findings were collected. Epilepsy was diagnosed based on clinical symptoms and EEG findings.

Results Of 100 neonates with HIE, 28 (28%) developed epilepsy by 6 months. Significant predictors included low Apgar score at 1 minute (≤3) (p 5 mmol/l) were associated with epilepsy (p=0.02). Abnormal EEG findings were observed in 78.57% of epileptic neonates (p<0.001). Logistic regression identified several independent predictors: Apgar score ≤3, early seizures, severe HIE, brain injury, elevated lactate levels, and abnormal EEG.

Conclusions Early clinical, biochemical, and neuroimaging factors are strong predictors of epilepsy in term neonates with HIE. These findings highlight the importance of early identification and intervention to improve long-term outcomes.