Skip to main content
Journal cover image

Characterization of Death in Infants With Neonatal Seizures.

Publication ,  Journal Article
Lemmon, ME; Bonifacio, SL; Shellhaas, RA; Wusthoff, CJ; Greenberg, RG; Soul, JS; Chang, T; Chu, CJ; Bates, S; Massey, SL; Abend, NS; Cilio, MR ...
Published in: Pediatr Neurol
December 2020

BACKGROUND: Neonatal seizures are associated with death and neurological morbidity; however, little is known about how neonates with seizures die. METHODS: This was a prospective, observational cohort study of neonates with seizures treated at seven sites of the Neonatal Seizure Registry. We characterized the mode of death, evaluated the association between infant characteristics and mode of death, and evaluated predictors of death or transfer to hospice. RESULTS: We enrolled 611 consecutive neonates with seizures, and 90 neonates (15%) died before hospital discharge at a median age of 11 days (range: 1 to 163 days); 32 (36%) died in the first postnatal week. An additional 19 neonates (3%) were transferred to hospice. The most common mode of in-hospital death was death after extubation amidst concerns for poor neurological prognosis, in the absence of life-threatening physiologic instability (n = 43, 48%). Only one infant died while actively receiving cardiopulmonary resuscitation. In an adjusted analysis, premature birth (odds ratio: 3.06, 95% confidence interval 1.59 to 5.90) and high seizure burden (odds ratio: 4.33, 95% confidence interval 1.88 to 9.95) were associated with increased odds of death or transfer to hospice. CONCLUSION: In a cohort of neonates with seizures, death occurred predominantly after decisions to withdraw or withhold life-sustaining intervention(s). Future work should characterize how these decisions occur and develop optimized approaches to support families and clinicians caring for newborns with seizures.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Pediatr Neurol

DOI

EISSN

1873-5150

Publication Date

December 2020

Volume

113

Start / End Page

21 / 25

Location

United States

Related Subject Headings

  • Withholding Treatment
  • Seizures
  • Risk Factors
  • Registries
  • Prospective Studies
  • Prognosis
  • Odds Ratio
  • Neurology & Neurosurgery
  • Male
  • Infant, Newborn
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lemmon, M. E., Bonifacio, S. L., Shellhaas, R. A., Wusthoff, C. J., Greenberg, R. G., Soul, J. S., … Neonatal Seizure Registry, . (2020). Characterization of Death in Infants With Neonatal Seizures. Pediatr Neurol, 113, 21–25. https://doi.org/10.1016/j.pediatrneurol.2020.08.002
Lemmon, Monica E., Sonia L. Bonifacio, Renée A. Shellhaas, Courtney J. Wusthoff, Rachel G. Greenberg, Janet S. Soul, Taeun Chang, et al. “Characterization of Death in Infants With Neonatal Seizures.Pediatr Neurol 113 (December 2020): 21–25. https://doi.org/10.1016/j.pediatrneurol.2020.08.002.
Lemmon ME, Bonifacio SL, Shellhaas RA, Wusthoff CJ, Greenberg RG, Soul JS, et al. Characterization of Death in Infants With Neonatal Seizures. Pediatr Neurol. 2020 Dec;113:21–5.
Lemmon, Monica E., et al. “Characterization of Death in Infants With Neonatal Seizures.Pediatr Neurol, vol. 113, Dec. 2020, pp. 21–25. Pubmed, doi:10.1016/j.pediatrneurol.2020.08.002.
Lemmon ME, Bonifacio SL, Shellhaas RA, Wusthoff CJ, Greenberg RG, Soul JS, Chang T, Chu CJ, Bates S, Massey SL, Abend NS, Cilio MR, Glass HC, Neonatal Seizure Registry. Characterization of Death in Infants With Neonatal Seizures. Pediatr Neurol. 2020 Dec;113:21–25.
Journal cover image

Published In

Pediatr Neurol

DOI

EISSN

1873-5150

Publication Date

December 2020

Volume

113

Start / End Page

21 / 25

Location

United States

Related Subject Headings

  • Withholding Treatment
  • Seizures
  • Risk Factors
  • Registries
  • Prospective Studies
  • Prognosis
  • Odds Ratio
  • Neurology & Neurosurgery
  • Male
  • Infant, Newborn