Features of cytokine status of the newborns with seizures

The aim of the present study was to assess the level of cytokines in newborn children of various gestational terms with seizures. A prospective, comprehensive study of 307 newborns of various gestational ages with seizures was carried out.

Evaluation of anamnestic data, antenatal, intrapartum risk factors with using statistical methods showed that mothers of newborns (respectively, full-term and premature) with seizures had a high percentage of extragenital diseases (31.8±3.7% χ² = 15.4, p = 0.009, vs 62.3±5.0% χ² = 27.2, p₁ < 0.001), gynecological disorders (49.1±3.6% χ² = 37.1 p < 0.001, and 47.0±5.1% χ² = 9.69 p₁ = 0.046), threatened miscarriage (9.1±2.5% χ² = 11.290 p < 0.001, and 28.5±4.7% χ² = 14.779 p₁ < 0.001), anemia of pregnancy (40.0±3.6% χ² = 14.9 , p < 0.001 vs 66.4±4.3% χ² = 18.9, p < 0.001). After EEG examination, we found that in most cases, 78 (30.0%) newborns exhibited polymorphic convulsions, i.e. a combination of different types of convulsions. The atypical convulsions were reported in 64 (24.5%) newborns, with a predominance of preterm infants 61 (40.4%). Clonic seizures were more common in full-term infants (n = 34; 30.9%) and preterm (n = 26; 17.2%). Myoclonic convulsions were found mainly in preterm newborns 21% (13.9%). Tonic convulsions were found in only 5 cases (5.3%). According to neurosonographic data, brain swelling was reported in 83 (31.8%), ventriculomegaly in 44 (16.9%), ventriculitis in 43 (16.5%), intraventricular hemorrhage in 66 (15.3%) newborns of the main group. In the control group, periventricular hemorrhage was observed in 37 (14.2%) newborns. Frequency of these disorders in preterm infants was 18.6% higher than in full-term infants (χ² = 13.3; p = 0.004). Altered immunological reactivity in newborns with seizures manifested as abnormal cytokine status and significantly elevated pro-inflammatory cytokines (IL-1β, 1.9-fold; IL-6, 3-fold; TNFα 3.3-fold increase) compared with newborns of control group. Increased concentration of pro-inflammatory cytokines in newborns with HIE is associated with maintenance of seizure activity and aggravates further unfavorable neurological outcome. The cerebral disorders and dysfunction of different organs and systems were found to correlate with immune parameters. Hence, the expression of pro-inflammatory cytokines may be used as a screening marker in diagnostics and prediction of neonatal seizures in presence of perinatal hypoxic-ischemic lesions of the central nervous system.