{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:23:54Z","timestamp":1775251434562,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003This study aims to describe the frequency and characteristics of anticonvulsant medication treatments initiated in the neonatal period.<\/jats:p><jats:p>\n          Study Design\u2003We 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 (\u2264 28 days postnatal) anticonvulsant initiation were calculated via modified Poisson regression.<\/jats:p><jats:p>\n          Results\u2003A 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\u2009=\u20090.015) and continuation at discharge (90.6 to 68.6%, p &lt;0.001). Levetiracetam (7.9 to 39.6%, p\u2009&lt;\u20090.001) initiation within the neonatal period and continuation at discharge (9.4 to 49.8%, p\u2009&lt;\u20090.001) increased. Neonates born at \u2265 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\u2009=\u20092,223, 44.4%).<\/jats:p><jats:p>\n          Conclusion\u2003Phenobarbital 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.<\/jats:p>","DOI":"10.1055\/s-0039-1698457","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T23:05:18Z","timestamp":1570748718000},"page":"469-476","source":"Crossref","is-referenced-by-count":10,"title":["Neonatal Antiepileptic Medication Treatment Patterns: A Decade of Change"],"prefix":"10.1055","volume":"38","author":[{"given":"Vi T.","family":"Le","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hibo H.","family":"Abdi","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo J.","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"},{"name":"Department of Pediatrics, The Ohio State University, Columbus, Ohio"},{"name":"Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio"},{"name":"Division of Pediatric Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Yossef","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia B.","family":"Reagan","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"},{"name":"Department of Economics, The Ohio State University, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurel A.","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Ohio State University, Columbus, Ohio"},{"name":"Division of Neurology, Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Firestine","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan L.","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio"},{"name":"Department of Pediatrics, The Ohio State University, Columbus, Ohio"},{"name":"Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio"},{"name":"Division of Epidemiology, The Ohio State University, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jpeds.2016.03.035","article-title":"Contemporary profile of seizures in neonates: a prospective cohort study","volume":"174","author":"H C Glass","year":"2016","journal-title":"J Pediatr"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.siny.2013.01.002","article-title":"Outcome following neonatal seizures","volume":"18","author":"C Uria-Avellanal","year":"2013","journal-title":"Semin Fetal Neonatal Med"},{"issue":"04","key":"ref3","first-page":"CD004218","article-title":"Anticonvulsants for neonates with seizures","author":"D Booth","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/0883073808321056","article-title":"Neonatal seizures: treatment and treatment variability in 31 United States pediatric hospitals","volume":"24","author":"H K Blume","year":"2009","journal-title":"J Child Neurol"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1038\/jp.2016.206","article-title":"Changing antiepileptic drug use for seizures in US neonatal intensive care units from 2005 to 2014","volume":"37","author":"K A Ahmad","year":"2017","journal-title":"J Perinatol"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/0883073812470734","article-title":"Pharmacological treatment of neonatal seizures: a systematic review","volume":"28","author":"L A Slaughter","year":"2013","journal-title":"J Child Neurol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.pediatrneurol.2007.04.003","article-title":"Neonatal seizures: multicenter variability in current treatment practices","volume":"37","author":"A I Bartha","year":"2007","journal-title":"Pediatr Neurol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.jpeds.2016.10.039","article-title":"Treatment duration after acute symptomatic seizures in neonates: a multicenter cohort study","volume":"181","author":"R A Shellhaas","year":"2017","journal-title":"J Pediatr"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"F70","DOI":"10.1136\/fn.78.1.F70","article-title":"Neonatal seizures","volume":"78","author":"D Evans","year":"1998","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"F267","DOI":"10.1136\/archdischild-2011-300716","article-title":"Cooling and seizure burden in term neonates: an observational study","volume":"97","author":"E Low","year":"2012","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jpeds.2013.01.041","article-title":"Therapeutic hypothermia in neonatal hypoxic ischemic encephalopathy: electrographic seizures and magnetic resonance imaging evidence of injury","volume":"163","author":"P Srinivasakumar","year":"2013","journal-title":"J Pediatr"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1111\/dmcn.13195","article-title":"Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic-ischemic encephalopathy: an observational study","volume":"58","author":"I Guidotti","year":"2016","journal-title":"Dev Med Child Neurol"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/0962280211427759","article-title":"Extension of the modified Poisson regression model to prospective studies with correlated binary data","volume":"22","author":"G Y Zou","year":"2013","journal-title":"Stat Methods Med Res"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/j.0006-341X.2000.00645.x","article-title":"A note on robust variance estimation for cluster-correlated data","volume":"56","author":"R L Williams","year":"2000","journal-title":"Biometrics"},{"issue":"15","key":"ref15","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1056\/NEJMcps050929","article-title":"Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy","volume":"353","author":"S Shankaran","year":"2005","journal-title":"N Engl J Med"},{"issue":"01","key":"ref16","first-page":"CD003311","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","author":"S E Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1038\/jp.2014.190","article-title":"Short-term outcomes after perinatal hypoxic ischemic encephalopathy: a report from the Children's Hospitals Neonatal Consortium HIE focus group","volume":"35","author":"A N Massaro","year":"2015","journal-title":"J Perinatol"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.siny.2017.07.008","article-title":"The use of phenobarbital and other anti-seizure drugs in newborns","volume":"22","author":"M El-Dib","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"issue":"23","key":"ref19","doi-asserted-by":"crossref","first-page":"15089","DOI":"10.1073\/pnas.222550499","article-title":"Antiepileptic drugs and apoptotic neurodegeneration in the developing brain","volume":"99","author":"P Bittigau","year":"2002","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"11","key":"ref20","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1038\/jp.2013.116","article-title":"Adverse neurodevelopmental outcomes after exposure to phenobarbital and levetiracetam for the treatment of neonatal seizures","volume":"33","author":"N L Maitre","year":"2013","journal-title":"J Perinatol"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1056\/NEJM199908123410704","article-title":"Phenobarbital compared with phenytoin for the treatment of neonatal seizures","volume":"341","author":"M J Painter","year":"1999","journal-title":"N Engl J Med"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"198","DOI":"10.3389\/fneur.2015.00198","article-title":"Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy\u2009-\u2009where to from here?","volume":"6","author":"J O Davidson","year":"2015","journal-title":"Front Neurol"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1203\/PDR.0b013e3181d4ff4d","article-title":"Phenobarbital augments hypothermic neuroprotection","volume":"67","author":"J D Barks","year":"2010","journal-title":"Pediatr Res"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/jp.2011.41","article-title":"Does phenobarbital improve the effectiveness of therapeutic hypothermia in infants with hypoxic-ischemic encephalopathy?","volume":"32","author":"S Sarkar","year":"2012","journal-title":"J Perinatol"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.expneurol.2005.01.006","article-title":"Sulthiame but not levetiracetam exerts neurotoxic effect in the developing rat brain","volume":"193","author":"D Manthey","year":"2005","journal-title":"Exp Neurol"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/pr.2012.151","article-title":"Antiepileptic effects of levetiracetam in a rodent neonatal seizure model","volume":"73","author":"D M Talos","year":"2013","journal-title":"Pediatr Res"},{"issue":"05","key":"ref27","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.earlhumdev.2012.12.002","article-title":"The effect of levetiracetam on neuronal apoptosis in neonatal rat model of hypoxic ischemic brain injury","volume":"89","author":"H Kilicdag","year":"2013","journal-title":"Early Hum Dev"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1055\/s-0037-1608653","article-title":"A systematic review of the efficacy of levetiracetam in neonatal seizures","volume":"49","author":"D C McHugh","year":"2018","journal-title":"Neuropediatrics"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.clp.2013.10.004","article-title":"Neonatal seizures: advances in mechanisms and management","volume":"41","author":"H C Glass","year":"2014","journal-title":"Clin Perinatol"},{"issue":"04","key":"ref30","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1891\/0730-0832.34.4.239","article-title":"Pharmacologic management of neonatal seizures","volume":"34","author":"B Zeller","year":"2015","journal-title":"Neonatal Netw"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"F346","DOI":"10.1136\/archdischild-2015-309639","article-title":"Management and investigation of neonatal encephalopathy: 2017 update","volume":"102","author":"K Martinello","year":"2017","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref32","first-page":"244","volume-title":"In-hospital databases","author":"B T Fisher","year":"2012"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.siny.2015.01.001","article-title":"Seizures and hypothermia: importance of electroencephalographic monitoring and considerations for treatment","volume":"20","author":"G B Boylan","year":"2015","journal-title":"Semin Fetal Neonatal Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1698457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T22:36:23Z","timestamp":1618266983000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1698457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,10]]},"references-count":33,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2021,4,12]]},"published-print":{"date-parts":[[2021,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1698457","relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,10]]}}}