Prenatal, perinatal and neonatal birth risk factors of children with epileptic encephalopathies

Abstract

The negative impact of perinatal factors on the brain can play a significant role in the etiopathogenesis of epileptic seizures in young children and the development of epileptic encephalopathies (EE). Purpose - to study the characteristics of the course of the prenatal and neonatal periods in young children with EE for the further formation of risk groups of children who need active monitoring. Materials and methods. An analysis of prenatal and neonatal features of anamnesis of 157 children with EE and their mothers was carried out. The children were divided into 3 groups: the Group I - children with EE who had the debut of epileptic seizures before the age of 1 year (n=75); the Group II - children with EE who had the debut of epileptic seizures after the age of 1 year (n=44); the Group III - children with epileptiform and developmental encephalopathies (EDE) (n=38). Results. The course of pregnancy in mothers of children with EDE is characterized by a high frequency of early gestosis, the threat of abortion in the second half of pregnancy and polyhydramnios (28.9%, 31.6%, 23.7%, respectively). Some (31.6%) of children with EDE were born prematurely, 21.1% by emergency caesarean section. Childbirth in mothers of children with EDE was characterised by a pathological course (44.7%), weakness of labor activity and prolonged dehydration (36.8% and 28.9%, respectively), and the birth of a child with distress (21.1%). The course of the neonatal period in children with EDE was characterized by a higher frequency of hypoxic-ischemic encephalopathy (23.7%) than in children with other forms of EE. In children of the Group I, syndromes of motor disorders (20.0%) and muscle hypotonia (17.3%) were more often observed. Conclusions. Aggravating factors of obstetric-gynecological and somatic anamnesis in women, and the course of prenatal and neonatal periods of life, which can act as a basis for the formation of EE and EDE in children, have been established. Among them are preeclampsia, placental pathology, changes in the amount of amniotic fluid during pregnancy, pathological childbirth, central nervous system depression syndrome and convulsive syndrome in infants. The obtained data will contribute to the formation of high-risk groups of children who need active monitoring. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.