Postnatal Steroids and Febrile Seizure Susceptibility in Preterm Children

Pediatrics. 2016 Apr;137(4):e20153404. doi: 10.1542/peds.2015-3404. Epub 2016 Mar 24.

Abstract

Objective: To investigate risk factors, seizure characteristics, and outcomes of febrile seizure (FS) in children born very preterm.

Methods: This study used a prospective registry data set of 844 preterm infants (birth weight <1500 g and gestational age <32 weeks) admitted to NICUs from 2001 to 2009 in southern Taiwan. We investigated the prevalence, risks, seizure patterns, and outcomes of FS in children aged 5 years.

Results: Among 575 children (follow-up rate, 85.8%) followed up for 5 years, 35 (6.1%) developed FS. The FS and non-FS groups were comparable regarding their mean gestational age, birth weight, 5-minute Apgar score <6, and prenatal and postnatal complications. No difference was observed in the use of prenatal corticosteroids between the 2 groups. The FS group had a significantly higher rate of postnatal corticosteroid treatment than the non-FS group, even after adjusting for confounding factors (odds ratio, 5.4 [95% confidence interval, 1.9-15.8]; P = .006). No differences were observed in IQs or subsequent epilepsy rates between the 2 groups. Although no difference was observed in the age of FS onset or neurodevelopmental outcomes between the 2 groups, children with FS who received postnatal corticosteroid treatment had a significantly lower mean body temperature during the first FS attack compared with those who did not receive postnatal corticosteroid treatment (38.6 ± 0.4°C vs 39.2 ± 0.6°C; P = .034).

Conclusions: Children born very preterm have a higher rate of FS, and postnatal corticosteroid treatment was associated with FS susceptibility in these children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Child, Preschool
  • Disease Susceptibility
  • Epilepsy
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Indomethacin / therapeutic use
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / drug therapy
  • Infant, Very Low Birth Weight
  • Magnesium Sulfate / therapeutic use
  • Male
  • Prospective Studies
  • Risk Factors
  • Seizures, Febrile / chemically induced*

Substances

  • Adrenal Cortex Hormones
  • Magnesium Sulfate
  • Indomethacin