SERUM PROLACTIN IN NEONATES WITH SEIZURES

We studied serum prolactin (PRL) in 28 newborn infants with acute ence phalopathy. Six patients had electrographically confirmed seizures. Tw enty-two patients comprised the nonictal group. In the seizure group, PRL was determined at the first onset of the seizure (baseline) and at 15 and 30 min postictal. In the nonseizure group, PRL was determined at the end of the EEG and 15 min later. EEGs were visually analyzed fo r the presence of seizures and background abnormality (normal or mildl y, moderately, or markedly abnormal). Etiologic diagnoses included con genital heart disease (12), hypoxic-ischemic encephalopathy (4), sepsi s (4), respiratory distress syndrome (5) meconium aspiration (1), and metabolic disease (2). Serum PRL was significantly higher (p < 0.05) a t baseline and 15 min postictally in the ever, PRL levels 15 and 30 mi n postictally were not statistically different from baseline values. B aseline PRL correlated significantly (p < 0.001) with EEG background a bnormality in both groups; therefore, patients with the most abnormal EEG backgrounds had higher levels of PRL than those with a relatively normal EEG background. We conclude that newborns with EEG-confirmed se izures, particularly if seizures are not associated with clinical sign s, have high baseline serum PRL levels that do not increase significan tly in the immediate postictal period. Serum PRL levels correlate with the severity of the brain insult as evaluated by EEG background. Furt her studies are needed to enhance our understanding of the dynamics of PRL secretion in newborns with seizures and acute encephalopathy.