Neonatal Antiepileptic Medication Treatment Patterns: A Decade of Change.
Am J Perinatol
; 38(5): 469-476, 2021 04.
Article
in En
| MEDLINE
| ID: mdl-31600794
ABSTRACT
OBJECTIVE:
This study aims to describe the frequency and characteristics of anticonvulsant medication treatments initiated in the neonatal period. STUDYDESIGN:
We analyzed a cohort of neonates with a seizure diagnosis who were discharged from institutions in the Pediatric Health Information System between 2007 and 2016. Adjusted risk ratios and 95% confidence intervals for characteristics associated with neonatal (≤ 28 days postnatal) anticonvulsant initiation were calculated via modified Poisson regression.RESULTS:
A total of 6,245 infants from 47 institutions were included. There was a decrease in both phenobarbital initiation within the neonatal period (96.9 to 91.3%, p = 0.015) and continuation at discharge (90.6 to 68.6%, p <0.001). Levetiracetam (7.9 to 39.6%, p < 0.001) initiation within the neonatal period and continuation at discharge (9.4 to 49.8%, p < 0.001) increased. Neonates born at ≥ 37 weeks' gestation and those diagnosed with intraventricular hemorrhage, ischemic/thrombotic stroke, other hemorrhagic stroke, and hypoxic ischemic encephalopathy (HIE) had a higher probability of anticonvulsant administration. The most prevalent diagnosis was HIE (n = 2,223, 44.4%).CONCLUSION:
Phenobarbital remains the most widely used neonatal seizure treatment. Levetiracetam is increasingly used as a second line therapy. Increasing levetiracetam use indicates a need for additional study to determine its effectiveness in reducing seizure burden and improving long-term outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Phenobarbital
/
Seizures
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Hypoxia-Ischemia, Brain
/
Levetiracetam
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Anticonvulsants
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
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Male
/
Newborn
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Perinatol
Year:
2021
Document type:
Article
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA